News 8/11/17

Top News

Allscripts will trade its significantly devalued 15 million shares in NantHealth for most of NantHealth’s provider and patient engagement solutions. That includes NantHealth’s FusionFx business, unstated “components of the NantOS software connectivity solutions,” and a guarantee that NantHealth will book an unstated minimum value of Allscripts product sales over a 10-year period.

The NH shares for which Allscripts paid $200 million two years ago are worth around $50 million. The company announced in last week’s quarterly earnings report that it will write down $145 million of its investment.

NantHealth’s FusionFx was part of its July 2015 acquisition of Harris Healthcare Solutions, which had previously acquired the former CareFx in early 2011 for $155 million in cash. That offering included HIE, patient and provider messaging, and single sign-on. 

NantHealth’s Patrick Soon-Shiong personally invested $100 million in Allscripts shares in the mid-2015 deal. He is down around $8 million as MDRX shares have fallen almost 10 percent since.

Meanwhile, NantHealth announces Q2 results: revenue up 17 percent, EPS –$0.58 vs. -$0.54. The company’s quarterly losses increased from $87 million to $111 million. NantHealth said in the earnings announcement that it will reduce headcount by 300 in a restructuring that will focus on cancer machine learning systems.

Soon-Shiong’s other publicly traded company, NantKwest, IPO’ed in July 2015, with a first-day closing share price of $34.64. NK shares now trade at $5.67.

Reader Comments

From Captain Beefheart: “Re: the term cloud-based. Several publications used this term for UCSD’s move to an Epic-hosted system. Epic isn’t really a cloud-based system just because they run the same product from their data center.” Health IT has long blurred the definition once it devolved from a technical term to a marketing one, simply renaming “hosted” systems (which also include the various forms of “just a longer cord” such as Saas, ASP, etc.) as being “cloud-based,” the same way “software” became “solutions” without changing anything. Googling didn’t turn up a firm definition of cloud-based systems, but here’s my best summary that begs for more technically astute readers to weigh in, with my interpretation being that calling Epic a “cloud-based system” is incorrect even though I’m guilty of having done so in UCSD’s case without really thinking about it:

• Connection to the remote system is via the Internet.
• The user organization doesn’t pay capital expenses but rather is billed at regular intervals based on a fixed monthly expense or for metered services.
• The hosting data center uses a shared pool of infrastructure (multi-tenancy) that can be managed virtually and provisioned on the fly. It is not simply moving the customer’s servers to a more distant data center owned by someone else.
• Customers can add or decrease system capabilities (bandwidth, server processing power, storage) on their own in flexing their metered capacity to their needs.
• The host manages the infrastructure and applies updates without using the customer’s resources.
• The host guarantees service levels for response time and downtime.

From Gene Gene: “Re: HIStalkapalooza. Wondering if you had reconsidered since we’re planning our own event and don’t want to compete.” I haven’t reconsidered. It’s a ton of work and a great financial risk for me personally without any benefit. I thought about it again a few months ago when: (a) we devised a new invitation/admission idea that would have eliminated much of the work, and (b) a company expressed interest in underwriting much of the cost in reducing my risk, but it didn’t work out. I have just one FTE (Lorre) for non-writing tasks and she spends ridiculous hours starting in early January trying to get event sponsors so I don’t go broke and arguing over who gets invited, not to mention that while we’re trying to set up and run our own little HIMSS booth, people are messaging both her and me nearly non-stop asking silly event questions or making unreasonable demands that reek of self-entitlement. RIP HIStalkapalooza, whose life reached its timely end at 10 years of age. HIMSS might actually be fun for us without all those headaches.

From Bilge Pump: “Re: Paragon. Why don’t you think Allscripts can sell it?” McKesson wasn’t having much luck selling it, so the question then becomes whether Allscripts has the sales force and channel to outperform McKesson in getting 150-bed hospitals to sign up for Paragon instead of Meditech, CPSI, Athenahealth, or even hosted Epic or Cerner systems that are admittedly overly complex for their needs. And while I admire the company’s upfront demarcation line of saying that Paragon will be pushed only for hospitals with fewer than 250 beds that offer no specialty services (of which there are quite a few), my cheap-seats experience is that vendors with overlapping products struggle with sales team infighting and confused prospects. Maybe Allscripts can move some of the Series and Star users to Paragon or the larger Paragon customers to Sunrise, but that won’t be a slam dunk – a project of that cost and magnitude requires a look at the other vendors who often win those deals and McKesson failed to accomplish that as well. They had better act quickly since the number of independent under-250 bed hospitals seems to be decreasing fast as they are acquired by health systems that mostly use Cerner and Epic. I would be interested in the customer count by bed range for all the inpatient EHR vendors if anyone has access to that information, although Cerner and Epic are playing the Electoral College-type strategy in focusing on enterprise size rather than a simple count of hospitals. 

From Denizen: “Re: Carequality. Our organization of long-term acute care hospitals was quoted $400,000 per year to onboard to Carequality as an implementer so we can get patient information from short-term acute care facilities, more than half of which run Epic. We don’t receive Meaningful Use incentives to help pay for this technology and we feel the costs are excessive given that the data belongs to the patient and it would allow us to provide them with better quality and safer care.” I contacted the non-profit Sequoia Project, which runs the eHealth Exchange, Carequality, and RSNA Image Share Validation. Their spokesperson explained:

Carequality is designed to connect networks and is not intended to be a network that providers directly join. As a result, the Carequality fees that you saw apply to the networks themselves, not to provider organizations who participate in a data sharing network. The assumption is that providers like this are already connected to a health data sharing network of some kind. If their “home network” is a Carequality implementer, then the provider should be readily able to connect to other Carequality connections. There are a number of health data sharing networks available in the market that this hospital may already be leveraging. Some of these networks are geographic-centric, such as regional and statewide HIEs. Others have a more nationwide focus, such as eHealth Exchange, Surescripts, and CommonWell Health Alliance. While still others are facilitated by the health IT vendor that the provider uses. Providers that would like to share health data via Carequality need to contact their participating network. If their network is not an implementer, they can encourage their network to implement the Carequality Interoperability Framework to dramatically expand their connectivity options.

From Non-Annoying Vendor: “Re: Stanford Health Care CIO position. Accepted by [name omitted].” I’ve emailed the person whose name I omitted for confirmation since it’s not cool to run unverified job changes. UPDATE: Verified. Eric Yablonka, VP/CIO of University of Chicago Medicine, emailed me to confirm that he will start at Stanford at the end of September. He replaces Pravene Nath, MD, who is now an executive in residence at Summation Health Ventures.

From Roman Hands: “Re: CHIME. It’s paying President and CEO Russell Branzell $500K per year, which seems like a lot for a non-profit whose revenue is less than $7 million.” Basically all of the $529K in member dues CHIME took in for FY2015 went toward Russ’s paycheck. It collected $1.6 million from conference registration and vendor advertising and $4.27 million from the CHIME Foundation. I’m not interested in doing compensation research, but one study I saw said that non-profit CEOs of organizations with budgets of $5 million to $10 million are paid an average of $100K. I remember doing some legwork years ago on Steve Lieber’s HIMSS compensation vs. similarly-sized member associations and he was certainly at the top of the chart (the current median is about one-fourth of what Steve makes). Whether either is worth the lofty salary is up to members to decide, not just in the amount of their dues, but how comfortable they are being pimped out to high-paying vendors that contribute most of the revenue.

HIStalk Announcements and Requests

This week on HIStalk Practice: The American Telemedicine Association looks for new leadership. A Chance to Change invests in telemedicine for behavioral health patients. Delaware physicians hope blockchain will speed up the prior authorization process. WellAve expands mobile dermatology clinic business. Colorado physicians up in arms over delinquent Medicaid reimbursements. ApolloMed takes a minority equity stake in LifeMD. Cow Creek Health & Wellness Center Clinic Director Dennis Eberhardt details the ways in which a new commercial EHR will better serve patients. Independent MDs express extreme dissatisfaction with MACRA. Buoy Health raises funding for symptom checker software.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

The New York Times profiles Eko Devices, started by three UC Berkeley undergrads. The company has sold 6,000 digital stethoscopes and will this fall introduce the FDA-cleared Duo, a prescription-only version for home use that collects EKG readings and heart sounds to send to doctors. One of Eko’s founders says the product should work like “Shazam for the heartbeat” in being able to recognize unusual heartbeat patterns just like the Shazam app can “listen” to a song being played and then display its title and artist. The Duo is intended only for heart patients and will cost $350 plus $45 per month. The Duo’s main competitor will be AliveCor’s Kardia, a $99 smart phone add-on that records EKGs.

People

Justin Diehl (Healthware Partners) joins Parallon Technology Solutions as VP of Epic services.

NHS England’s first chief clinical information officer, Keith McNeil, MBBS resigns after 13 months, returning to Australia to become CMIO of Queensland Health.

Announcements and Implementations

AdvancedMD launches AdvancedReputation, which automatically emails or texts patients a one-question satisfaction poll following their office or telemedicine visit and invites those who score positively to post their feedback on the practice’s Google business profile. Those who score negatively are asked to describe their experience to be posted privately to the provider’s dashboard.

Christus Health reports its results from implementing Epion Health’s iPad appointment check-in system: collections per encounter increased 3.5 percent, patient portal sign-ups increased 300 percent, and 21,000 patients opted in for text messages. Epion CEO Joe Blewitt graduated from the United States Air Force Academy, was on active duty in the Air Force for 10 years, then spent 17 years as an Air Force Reserve pilot at McGuire Air Force Base.

Change Healthcare adds the capability of adding attachments to dental claims submissions.

Government and Politics

The Austin, TX paper reviews the state’s lawsuit against Xerox, which the state says did shoddy pre-authorization reviews for Medicaid dental services. The company hired high school dropouts and gave them just a one-hour training session. One of them responded to a deposition question about the definition of severe handicapping malocclusion, “Not a clue. Their teeth are messed up.” Records show Xerox ran the process like a high-pressure boiler room where supervisors ordered employees – many of whom worked from home and thus couldn’t even see the records that had been submitted by dentists – to “push those keys as fast as you can.” Xerox hired just one dentist to review hundreds of requests each day, with one such review being clocked at exactly six seconds. HHS OIG ordered the state to repay it $133 million for services it had paid that didn’t pass pre-authorization rules. Records show the state knew about the rubber-stamped authorizations but did nothing for several years, eventually culminating in the firing of Xerox and the lawsuit brought against the company in hopes of covering the HHS repayment.

President Trump declares the opioid crisis a national emergency, contradicting a statement made two days ago by HHS Secretary Tom Price, who said such a declaration is unnecessary. 

Australia’s government approves automatic sign-up of citizens for its My Health Record provider and patient e-health system, formerly known as PCEHR. People will have to opt out if they don’t want their information shared. The government hopes to approve interoperability standards in 2022 and to make secure provider-patient and provider-provider communication universally available the same year. The government published its national digital health strategy this week. Reports suggest that the government has spent at least $1 billion on My Health Record, which has struggled with poor patient and provider participation.

Oregon’s governor demands and receives the resignation of the head of its health authority following leaking of a document describing her planned smear campaign against a Medicaid provider who sued the state claiming that the agency’s rate-setting process is not fair.

Privacy and Security

Princeton Community Hospital (WV) is still down from its June 27 malware attack, saying it is dealing with a transcription backlog and interfaces that aren’t working yet following its complete rebuilding of systems.

Technology

CNBC covers the potential use of the Amazon Echo for helping homecare patients with medication reminders, instructions, and staying connected with family. It mentions voice startup Orbita, which offers an Amazon Alexa skill and a graphical development tool for Amazon Echo, Google Home, and other voice platforms.

Other

This should help dispel those negative perceptions of Alabama.

In South Australia, 20 percent of surveyed doctors say the government’s EPAS electronic health record is causing medication errors, critical delays, and pathology mistakes, with one-third of respondents saying the Allscripts system has caused near-misses. 

State auditors accidentally find that a struggling 15-bed Missouri hospital was apparently used as a shell company to bill $90 million worth of lab tests that were performed by other hospitals run by the same management company that installed its president as the hospital’s CEO. The auditors also found that the CEO and his company were paid nearly $1 million in the first 10 months of the agreement, the hospital paid $10.6 million to the hospital company’s lab division in just three months, and the hospital was covering the salaries of 33 phlebotomists of other company-run hospitals. The state, which is considering a corruption investigation, says decisions made by the hospital’s management and board were “astounding in their irresponsibility.” The CEO has charges pending against him in Louisiana related to a another managed hospital’s claims that he forged checks made out to another management company he owned. The state auditor says the hospital did no background checks and minimal due diligence before turning its operations over to the management company and CEO.

A Texas Public Radio report covers the dispute between Nuance and its remote workers following its extended malware-caused downtime, during which the company’s transcriptionists say they were promised overtime and incentive pay that was later rescinded. The report reviewed the recording of a management conference call for transcriptionists in which Nuance clarified that the incentives it had offered (and that its managers had promised) were not intended for all transcriptionists, but said its message was misunderstood because its communications systems were also down due to the malware. One employee who worked more than 12 hours per day saw that her expected $3,000 extra payment ended up being just $21. The recorded call also captures a Nuance manager who explained that the error was widespread, adding, “We blew it. We completely blew it.” The article concludes that it’s tough for remote workers to react to employment conditions since they can’t band together to protest in person. They may still get their chance – several lawyers added their contact information to the article’s comments.

Sponsor Updates

• CSI Healthcare IT completes its at-the-elbow support for the Epic ambulatory go-live at Atlantic Health System (NJ).
• Meditech will exhibit at the Mid-South Critical Access Hospital Conference August 16-18 in Nashville.
• Spok announces that all 20 of the hospitals on US News & World Report’s list of best hospitals as well as all 10 of the best children’s hospitals use its solutions for enterprise healthcare communications.
• Netsmart will exhibit at the FADAA/FCCMH Annual Conference August 16 in Orlando.
• Experian Health will exhibit at the HFMA Arkansas Summer Conference August 16-18 in Hot Springs.
• PatientPing names former Medicare deputy administrator and director Sean Cavanaugh as an advisor.

Blog Posts

• Meditech’s Fetal Monitor Interface Improves Nursing Workflow at Beaufort Memorial (Meditech)
• A Constant in a Sea of Change (Spok)
• Malware got you down? Get 3 no-regrets strategies to protect your IT contracts (Advisory Board)
• Getting the “Ops” in DevOps Right (LogicWorks)
• 3 Considerations when Planning Epic Upgrades (Optimum Healthcare IT)
• As You Wish … Best Practices for Gaining Physician Buy-in for Your Revenue Cycle Wish List (Navicure)
• Home Health Rule Will Bring Big Changes in 2018 and 2019 (Netsmart)
• How to Maximize Value from Healthcare’s Digital Transformation (PatientKeeper)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 8/9/17

Top News

UC San Diego Health (CA) moves from its self-hosted Epic system to an Epic-hosted, cloud-based system, the first academic medical center to undertake that particular migration.

UCSD says it is shifting away from running its own hosted centers to cloud-based systems because of cost and reliability. The Epic switch involved 10,000 workstations and integration of 100 third-party applications.

UC Irvine Health will move to UCSD Health’s Epic cloud-based instance in November 2017.

UC San Francisco announced a $10 million grant in late July that will fund a project to mine the combined Epic databases of all five UC medical centers to discover new insights and possibly find new uses for existing drugs.

Reader Comments

From Sister Sledge: “Re: Allscripts. One of the rags ran a map of where McKesson EIS had customers, claiming that geography matters to a vendor and that Allscripts will benefit from gaining more customers in the West. Think so?” I don’t think so. Geography can affect sales, but only for companies that have clear momentum and neither McKesson nor Allscripts have ever had that. My prediction is that Cerner, Epic, and maybe Meditech will benefit most when those customers start looking for replacement systems. It’s not at all similar to when Cerner bought Siemens Health Services and could offer them a lifeline from their rapidly sinking systems to a market-leading one. Allscripts can boast about a higher customer count or wider geographic reach, but a lot of those customers are likely to defect in the next few years as the Cerner and Epic train keeps rolling over everything in its path (accelerated by big hospitals buying smaller ones) and the acquisition encourages those former McKesson customers to review their positions. The direction of change in customer satisfaction post-acquisition will predict a lot. MDRX shares are at the same price as they were in mid-1999, so stock performance won’t create much confidence – Cerner shares are up 322 percent in the past 10 years, McKesson shares are up 167 percent, and the Nasdaq index is up 136 percent, all while Allscripts shares were losing 52 percent of their value. 

From Lucille Two: “Re: Epic’s response to Politico’s article about Joe Biden. Don’t you find Epic’s PR statement a bit confusing, saying that the VP was ‘consistently polite and positive’ unless it’s to cover their tracks? Wouldn’t Biden’s staffer, who has no reason to disparage him, know him well enough?” Politico excerpted comments from a video made at a conference’s fireside chat by Greg Simon, now president of the Biden Cancer Initiative, who said the VP and Epic CEO Judy Faulkner got into a heated exchange over why Biden might want his own full medical record. I wasn’t there and Simon was, but my observations from watching him tell the story on video are:

• Simon seemed a bit swaggering and over-the-top in the video, which left me feeling that his comments were more of an entertaining story for the in-person conference audience rather than a trustworthy, verbatim discussion of what was said by others in his presence.
• Simon’s tone in the remainder of his remarks was clearly anti-EHR vendor. I got the feeling that the Biden story was his chance to take a shot at them. 
• The conversation between Biden and Faulkner he described took place nearly seven months ago, resulting in zero reaction until the conference video from Simon’s session was published.
• Simon’s background: aide to VP Al Gore, lobbyist, charity founder, drug company executive. He’s long been a critic of the lack of data-sharing in healthcare, but he originally seemed to blame providers rather than EHR vendors in saying, “The technology of sharing has increased exponentially, but the willingness to share has not.” 
• Others in attendance (it was not a private meeting) have not corroborated Simon’s account, and in fact have said the meeting was, as Faulkner said, cordial and polite.
• Even accepting Faulkner’s supposed comments at face value, it’s a leap to assume that her message was dismissive, paternalistic, or defensive about patients accessing their data. Tone is everything and her supposed comment that Biden wouldn’t be able to make sense out of an Epic EHR data dump is generally accurate, although perhaps Biden took offense thinking he was being spoken down to.
• The bottom line for me is that it’s much ado about nothing regardless of whether Simon’s recap is accurate. It was a fun story for a couple of days, but not necessarily accurate or indicative of any particular trend or practice, especially in the absence of commentary from Biden himself. If he were that riled up, he’s had seven months to say so.

HIStalk Announcements and Requests

I notice that Rolling Stone has a profile of singer-songwriter Khalid mentioned on the cover of the current issue, mostly because I recommended his music in January 2017 with my summary, “Mark your calendars for six months from now – Khalid is going to be big.” 

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Pharmacy supply chain technology vendor Swisslog Healthcare acquires Talyst Systems, which offers medication management solutions to acute care and long term care facilities. 

Evolent Health reports Q2 results: revenue up 89 percent, EPS –$0.13 vs. –$0.25, beating revenue expectations and meeting on earnings. News of the company’s plan to launch a $175 million secondary public offering  sent shares down 17 percent in early after-hours trading Tuesday.

Sales

Connecticut Children’s Hospital chooses InstaMed’s healthcare payments solution.

Toronto-based Baycrest Health Sciences selects Caradigm’s single sign-on and context management systems.

People

Stephen Grossbart, PhD (Stephen Grossbart and Associates) joins Health Catalyst as SVP of professional services.

Ingenious Med hires Girish Pathria (Visiant) as VP of products and insights and names Nancy Cunningham (Accord Services) as VP of implementations.

Susan Steagull (Novant Health) joins VCU Health System (VA) as CIO.

Announcements and Implementations

Fresno Surgical Hospital (CA) goes live on FormFast’s electronic signature solution in its Meditech environment.

Privacy and Security

The now-retired NIST manager who in 2003 was ordered to quickly develop password-setting guidelines says he was wrong about recommending that passwords be required to conform to bizarre rules that require mixed-case letters and special characters. New NIST guidelines recommend that passwords be created from long but easily-remembered phrases. Analysis found that a password like “correcthorsebatterystaple” would require 550 years to crack, while an old-rules version such as “Tr0ub4dor&3” could be broken in just three days. The guidelines also say that passwords need not be auto-expired, with users forced to change their passwords only if they are known to have been compromised.

In India, a hospital IT director and one of his former employees are arrested for stealing hospital data required for accreditation and selling it to other hospitals.

Other

A study of all US opioid prescriptions issued over a nine-year period finds that doctors who graduated from low-ranked medical schools prescribe a lot more opioids than those who attended top-tier programs, concluding that physician educational outreach might help with overuse. Based on the graph above, it looks like osteopaths (DOs) are a much bigger problem than just about everyone else, including foreign medical graduates, although that wasn’t the subject of the study. I’m not sure I buy the conclusion, however, since it would be interesting to also look at number of years since graduation and the practice location — I would bet that many graduates of top-ranked schools tend to practice locally afterward and have a different kind of peer group and big-hospital oversight that happens mostly in major teaching hospitals with employed doctors. The bottom-ranked schools, in case you are as interested as I am, are Drexel, University of Nevada, Michigan State, West Virginia University, and University of South Carolina, which might be especially concerning if your doctor finished at the back of the pack of his or her graduating class.

Oopsie.

A researcher observes with some alarm that post-Millennials are “on the brink of the worst mental health crisis in decades” because they spend all their free time on Snapchat or texting instead of physically interacting with people, with a steep drop-off in time spent with friends even though virtual interaction leaves them less happy. Those who proudly document their activities on social media also cause everybody else to feel left out or to obsess over how many “likes” they earn. In a somewhat related article, a small study finds that AI-powered analysis of Instagram photos (color, comments, likes, posting frequency) is much more accurate at diagnosing depression than face-to-face doctor visits.

Giving employees a healthcare price transparency tool didn’t reduce overall spending, a study finds, noting that only 12 percent of the employees even bothered to look at it. The price tool saved an average of 14 percent of the cost of advanced imaging studies, but only 1 percent of those patients consulted the tool before having the test performed.

We are so blessed in healthcare IT to have access to a $3,480 report written by obvious experts.

In Egypt, 10 doctors launch an operating room-themed restaurant that claims its food is safer because of the medical training of the owners.

Sponsor Updates

• Aprima will host its annual user conference August 18-20 in Dallas, TX.
• Besler Consulting releases a new podcast, “Preparing for the Social Security Number Removal Initiative.”
• Optimum Healthcare IT publishes a white paper titled “Epic Upgrades are Epic Events.”
• Nordic publishes a podcast titled “Why change management is critical to a successful EHR transition.”
• EClinicalWorks announces that users of its EHR have exchanged two million documents in the past 12 months through the Carequality Interoperability Framework.
• Dresner Advisory Services honors Dimensional Insight with its Industry Excellence Award for business intelligence expertise.
• Glytec showcases the impact its therapy management software along with connected device systems has on insulin management at the American Association of Diabetes Educators conference.
• Healthfinch VP of Operations and Finance Leah Roe will speak at Forward Fest Madison August 17-24 in Wisconsin.
• Influence Health announces the speaker lineup for its Influence! Healthcare Consumer Experience Conference September 27-28 in Orlando, FL.

Blog Posts

• Why Can’t We Put Our Cell Phones Down? (Direct Consulting Associates)
• ONC Approves NCQA’s Alternative Electronic Clinical Quality Measure testing method (Diameter Health)
• The Downside of Data Science (Dimensional Insight)
• Experience (and Relationships!) Impact Our Health Outcomes (Docent Health)
• Changing nutrition habits to boost community health (EClinicalWorks)
• Rapid reviews and recognition are all the RAVE (Infor)
• Top Ways Meditech is Committed to Interoperability (Meditech)
• Redefining Awareness Month Success – Strategies for More Effective Breast Cancer Awareness Campaigns (Evariant)
• Overcoming 3 Healthcare Data Analytics Challenges with Intelligent Analysis (Hayes Management Consulting)
• Archiving: Your Healthcare Cybersecurity Strategy (The HCI Group)
• Hospital and Healthcare IT Survival Guide for the Post-EHR Era (Iatric Systems)
• How are Your Employees Motivated in a Crisis? (Impact Advisors)
• Community Hospital Anderson Ensures Positive Patient Identification (Imprivata)
• The Need for Speed in Healthcare CMS (Influence Health)
• The True Cost of Paper for Payers (InstaMed)
• Precisely Speaking – Part 2 (InterSystems)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 8/7/17

Top News

Allscripts will write down $145 million of its $200 million investment in NantHealth, whose shares have dropped 77 percent since the investment. Allscripts said in its earnings announcement, “This impairment is based on management’s assessment of the likelihood of near-term recovery of the investment’s value.” Shares in NH, which closed at $18.59 on their first day of trading in June 2016, are now at $4.20, valuing the company at $510 million.

Allscripts says it will exchange its NantHealth ownership stake for “certain technology assets and client relationships” of NantHealth as well as a commitment that NantHealth will buy Allscripts software and services.

Other items from the Allscripts earnings call:

• Allscripts CEO and long-time Cerner executive Paul Black opened the call by offering his condolences to Neal Patterson’s family and colleagues.
• Black says executives have been talking for some time about the need to boost the company’s inpatient EHR market share, with the McKesson EIS acquisition adding hundreds of new inpatient clients who present cross-selling opportunities for systems for EHR, post-acute care, population health management, and precision medicine.
• The company signed the largest Sunrise agreement since 2011 with a six-hospital system.
• President Richard Poulton said in response to an analyst’s question about why the company would take on the risk of buying McKesson EIS, “This is an industry that is going to continue to transition. You can go around the horn for both inpatient and outpatient competitors and you’d find several of them are either for sale actively, have been recently for sale, or will be for sale most likely in the not too distant future … as the market matures, consolidation is a natural occurrence and it’s inevitable.”
• Poulton says what’s left of the retired Horizon business will wind down within two quarters of the acquisition’s closing.
• Allscripts hopes to improve the McKesson customer defection rate that started when it announced plans to exit healthcare IT.
• The company says it will recommend Paragon for under-200 bed hospitals with simple product and service lines and Sunrise for larger, more complex health systems. Poulton admits that the company found it hard to sell Sunrise into small hospitals because of the effort required to implement it and the difficulty for a small hospital to get full value from it, adding that competitors have reached the same conclusion.
• Asked which McKesson solutions might appeal to Sunrise customers, Black listed lab, blood bank, surgery, anesthesia, the OneContent document management system, and supply chain.

Reader Comments

From Tater Consultancy: “Re: Epic. The contract from a just-signed Epic site says Care Everywhere is licensed via a transaction fee for each CCD exchanged with a non-Epic EHR. Epic made a big deal at HIMSS15 about waiving the $2.35 per record fee due to industry pressure. Looks like not much has changed, although a specific fee isn’t mentioned in the contract.“ Judy Faulkner said at HIMSS15 that data exchange via Care Everywhere would be free “at least until 2020.” Fees prior to that were $0.20 for each message sent to an HIE and $2.35 per year for a given patient for whom messages were received from foreign EMRs regardless of the message count. About that time, Athenahealth said it would pay customer fees for participating in CommonWell indefinitely and Cerner promised to do the same through at least 2017. I’m happy to run any fee updates from Epic, Athenahealth, or Cerner customers. I summarize with my common conclusion: Q: Why do vendors charge xxx? A: Because they can, and because customers keep signing those contracts. UPDATE: an Epic spokesperson says the company has not broken the 2020 promise — CCD exchanges are free, also adding, “In our new contracts, CCD exchanges with non-Epic EHRs are free indefinitely, and this is a standard we are applying to both new and existing customers, regardless of what their contract says.”

From Confused Consultant: “Re: Summa Health. Cutting 300 jobs to cover a $60 million operating loss. Implemented Epic from Catholic Health Partners last year while claiming they want to remain independent as the city’s largest employer, turning over what is likely their largest non-personnel expense line to a larger IDN who might be a likely purchaser. I’m not saying it’s the case here, but some mega systems wield Epic as an instrument to influence referral patterns or M&A activity, and industry narrative that has been largely unnoticed by trade media.” Summa made a PR and professional mess of its ED staffing change early this year and large physician groups started sending patients elsewhere due to quality concerns, both of which gave it a community black eye even before this latest financial bombshell. It’s also located in Akron, an industrial city whose population is declining and skewing older. Still, I agree that a larger, Epic-provisioning organization might get first dibs at acquiring a given hospital that uses its services. That could be for several reasons: a successful, non-competitive working relationship; the smaller hospital’s willingness to outsource a key service and its underlying motivation to do so; more transparent referral patterns; and if the organizations indeed express acquisition interest, access to better due diligence data and a potentially smoother transition afterward. My conclusion is that large health systems are acquiring smaller ones that stumble operationally or financially and technology makes it more attractive. Good or bad, we seem to be heading toward big regional and national health systems owning most hospitals, a situation that is almost universal in every industry outside of healthcare.

From Art O. Deal: “Re: VA. The taxpayer watchdog in The Hill makes the same point you’ve made about Shulkin (Trump) giving away leverage by no-bidding the VA.” The president of Taxpayers Protection Alliance says no-bid contracts have become the rule rather than the exception at many federal agencies, observing that the Department of Defense spent more than $100 billion in 2016 — more than half of its spending — via non-competitive contract awards. It questions the assertion of Secretary of Veterans Affairs David Shulkin that the VA “can do this cheaper for the taxpayers by essentially moving forward quickly without a lengthy process” when he has no idea how long the project will take or what it might cost. President Trump and White House advisor Jared Kushner both bragged on pushing the VA to choose Cerner without exploring the only viable alternative (Epic) or sticking with VistA, with Shulkin obediently framing the choice as obvious since the DoD is already implementing Cerner. The Trump clan brags about being skilled deal-makers – at least when it’s their money and not that of taxpayers —  but telling a vendor they’ve been chosen without first hashing out a contract is about as amateurish as you can get. I think everybody, especially Congress, was just sick of DoD and VA making excuses why they can’t exchange information, with active service military members starting over with a nearly blank page after transitioning to veteran status. 

From Compromized Consumers: “Re: Optum 360. Will obtain patient records of UnitedHealthcare members and dependents, not just claims and EOB, but also labs and prescriptions. They will then build a personal health record similar to Microsoft HealthVault. To avoid regulator and consumer rights backlash, they will partner with someone like Apple or Experian, with the final solution marketed as a consumer convenience under the partner’s name. This update will be shared with VIPs attending the Optum event in DC this week.” Unverified.

HIStalk Announcements and Requests

Poll respondents give their largest local non-profit health systems mixed marks on serving patients selflessly, with 44 percent grading them A or B, 29 percent a gentleman’s C, and 27 percent going with D or F.

New poll to your right or here: who will benefit most from the proposed acquisition of McKesson EIS by Allscripts?

HIStalk readers funded the DonorsChoose teacher grant request of Ms. M in Missouri, who asked for science books and weather kits. She reports, “You have awakened a love for science in my classroom! Our new materials have allowed us to get knee-deep into our content. Having the chance to put together a pulley system gave students the opportunity to really see how they work, and to decide for themselves that they do lighten the amount of work it takes to lift an object. The power of seeing this first-hand really helped the concept to stick! In the same way, the model we put together to show how the moon rotates around the earth gave rise to a number of interesting discussions. Students were able to seek answers to their own questions and share these with their classmates. This went so far beyond what a normal paper-and-pencil lesson could have done.”

This Week in Health IT History

One year ago:

• Theranos CEO Elizabeth Holmes announces in her AACC Q&A session that the troubled company will pivot into manufacturing the MiniLab sample processing machine.
• Drone delivery vendor Zipline says it will deliver medical supplies to areas of Maryland, Nevada, and Washington within a year.
• Senator Elizabeth Warren’s NEJM opinion piece recommends that underlying data from submitted journal articles, as well as from both successful and failed clinical trials, be shared openly.
• Hackers breach Newkirk Products, which issues BCBS insurance cards in several states.
• A New York Times article questions whether “did we control your pain” hospital satisfaction survey question encourages doctors to over-prescribe opiates since satisfaction scores impact their bonuses.

Five years ago:

• Massachusetts announces that it will create a statewide HIE, paid for by the federal government.
• McKesson announces Cardiology Inventory and Surgical Point-of-Use Integration Module.
• The VA begins implementing the first sites of its $543 million RTLS contract, with HP as the prime contractor.
• Allscripts CEO Glen Tullman says in an earnings call after the company fell short on earnings that Sunrise Financial Manager will be released in Q4, it expects to win more hospital business as competitors step away, and that demand for the company’s open, less-expensive hospital systems will grow.

Ten years ago:

• The CEO of Lawson Software says software-as-a-service won’t live up to its hype.
• Perot Systems acquires JJWild for $89 million in cash.
• IMedica reports that its customer base grew 76 percent in the first six months of the year.

Weekly Anonymous Reader Question

Responses to last week’s question:

• Chased love, laughter, and friendship, not money and fame. Crossed the finish line a WINNER.
• You can never have enough rope!
• Appears he didn’t hear us yell “Duck!”
• That reminds me of a story…
• When I die at the age of 103: “Life – like me – was short, but sweet.”
• The “Clean up Woman.”
• She put the fun in dysfunctional.
• Have a drink on me. (with a bottle opener mounted on the tombstone).
• When I am dead and gone and my time on earth has passed, I hope they bury me upside down, so my critics can kiss my a$$.
• I told you I was sick!
• It’s too hard not to have a good time.
• And now, for something completely different…
• Oh what a tangled web we weave when first we practice to deceive.
• Faithful to us here, we loved him to the last.
• He left life better than he found it.
• He found love, joy. and peace in family.
• S/He was born at a young age, and lived until the end.
• Adventure.
• Cheer up, there’s no hope.
• The measure of what a human being could be.
• He had nothing, but gave it his all.
• I told you so.
• Made a positive difference in numerous lives by being alive and was a great friend.
• She made a difference.
• Smart from the start, caring and overbearing, made a difference with little deference.
• The most difficult thing she ever did was live when all she wanted was to die.
• Veni, vidi, vici.
• That was fun!
• Mostly sorry for before 25. I spent the next 50 working to even the balance.
• Left this world wondering what difference she made. Hopefully will find out now.
• He tried every day to be the man his dog thought he was.
• Been there, done that.
• A joyful scoundrel gone, not forgotten.
• This was harder than I thought!
• Life is too important to be taken seriously. Smile.
• No situation is so bad that it can’t get worse.
• I tried really hard.

This week’s question: of the places you’ve experienced, where would you choose to live if job or money wasn’t a factor?

Last Week’s Most Interesting News

• Allscripts announces that it will acquire McKesson’s Enterprise Information Solutions business for $185 million in cash.
• The VA announces expansion of its telemedicine program, including allowing its employed providers to conduct sessions across state lines.
• A Politico report claims that then-VP Joe Biden scolded Epic CEO Judy Faulkner in a January 2017 meeting for her questioning him as to why he would want his complete medical records, which Epic says is an “inaccurate and misleading” description of his meeting with EHR vendors.
• Drug maker Merck warns that its manufacturing process is still being disrupted by its June 27 malware attack and warns of potential drug shortages and unknown financial impact.
• Athenahealth announces that it will target $100 million in cost savings and strips Jonathan Bush’s president and board chair titles in recruiting replacements.
• Quality Systems says it has received a Civil Investigative Demands letter from the Department of Justice and says it has heard of other vendors receiving the same letter, which involves a false claims investigation such as the one that cost EClinicalWorks a $155 million settlement.
• The White House’s opioid crisis committee recommends that state doctor-shopping databases be connected and that the government relax the HIPAA requirement that prevents addiction treatment professionals from sharing patient information with other providers without consent.
• A $10 million donation will fund the launch of a UCSF institute that will perform analytics-based drug discovery using a newly created dataset covering all five UC system medical centers.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Decisions

• Wadley Regional Medical Center At Hope (AR) will go live with Cerner in December 2017.
• Sartori Memorial Hospital (IA) will switch from McKesson to Cerner in October 2017. Its clinic will remain on an Epic ambulatory EHR.
• Hereford Regional Medical Center (TX) will switch from Healthland (a CPSI company) to Cerner next month.
• Select Specialty Hospital – Danville and Gainesville (PA) plans to switch to Epic.
• Regency Hospital Of Central Georgia will go live with Epic in 2019.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.

Announcements and Implementations

The Madison business paper profiles the recent launch of Datica’s Digital Health Success Framework that helps startups get their products to market.

Privacy and Security

It’s tough to stay on the pedestal once placed there. The security researcher who single-handedly stopped the May 2017 WannCry ransomware attack is arrested at the Las Vegas airport while boarding a plane back home to the UK after attending the DefCon hacking conference, charged with creating and then selling malware that targeted banks in 2014-2015.

Siemens warns users of several of its molecular imaging systems that those systems could be easily hacked remotely because of bugs in their Windows web server and HP Client Automation Service software. The company is working on a patch, but recommends in the meantime that the Windows 7-powered machines be disconnected from the network or run on isolated network segments. 

Other

Pharma bro Martin Shkreli is convicted on three counts of securities fraud charges, for which he faces up to 20 years in prison. Prosecutors say Shkreli ran a Ponzi-like scheme in which he convinced people to invest in his hedge funds by falsely claiming he knew what he was doing, then lost a lot of their money and diverted some of the funds to start up a drug company while falsely claiming positive returns and giving the runaround to investors who wanted to cash out. All of that is unrelated to his turmoil-filled time at Turing Pharmaceuticals, which bought an old, cheap drug that is still sometimes useful in treating AIDS and raised its price by 5,000 percent. As I observed above: Q: Why do vendors charge xxx? A: Because they can. Behavior that some might find despicable isn’t necessary illegal.

Ireland’s Health Services Executive says the recently publicized national imaging system bug that caused the “less than” symbol to be omitted from reports was discovered in January 2016 by the system’s vendor, Change Healthcare, who didn’t let customers know about the problem until it was fixed in August 2016. Change Healthcare became the vendor in its recent merger with most of McKesson’s health IT business. The company’s Canadian subsidiary, McKesson Medical Imaging, reportedly sent out a field safety notice this week to all customers, many of which are in the US.

Here’s the next-to-last installment of Vince’s series on Cerner from a few years back.

Sponsor Updates

• The Summit Healthcare team sorted through 10,000 pounds of food while volunteering at The Greater Boston Food Bank.
• The SSI Group will exhibit at the HFMA Region 8 conference August 7 in Kansas City, MO.
• ZappRx is nominated for Xconomy’s inaugural Life Science Awards
• A Datica podcast features an interview with Naomi Fried, PhD on digital health companies supporting drug company innovation. 

Blog Posts

• Digital health systems: A foundation for IT-powered innovation (Advisory Board)
• Women in Health Tech: Star Cunningham, 4D Healthware (Redox)
• Why CIOs and IT Leaders are Prioritizing Customer Experience (Salesforce)
• Healthcare Analytics Soar to New Sights (The SSI Group)
• Here Today, Gone Tomorrow: Alarming Trends in Patient Satisfaction (Solutionreach)
• St. Louis-based Health System Embraces Technology to Strengthen Care Coordination (Surescripts)
• Five tips for getting your proactive HEDIS runs to take off (Verscend Technologies)
• Even small hospitals have big communication challenges. (Voalte)
• 5 Keys for Exceptional Customer Experiences (West Corp.)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

News 8/4/17

Top News

Allscripts will acquire McKesson’s Enterprise Information Solutions health IT business for $185 million cash. McKesson EIS offers Paragon EHR, Star, Series, Healthquest, Lab Analytics and Blood Bank, and OneContent.

Allscripts plans to offer Paragon to small hospitals while continuing to market Allscripts Sunrise to larger health systems.

McKesson announced in June 2016 that it was exploring strategic alternatives for the EIS business as it merged most of its IT offerings with Change Healthcare. It wrote off $290 million in October 2016 related to the EIS business. McKesson will apparently retain RelayHealth and its recently acquired CoverMyMeds, both network-focused, high-growth communications products that are aimed more at pharmacies and insurance companies than health systems.

Meanwhile, Allscripts reports Q2 results: revenue up 10 percent, adjusted EPS $0.15 vs. $0.14, meeting earnings expectations and beating on revenue. MDRX share priced dropped 18 percent in the past year in valuing the company at $2.1 billion.

Allscripts shares rose 16 percent in after-hours trading immediately following the acquisition and earnings announcements.

Reader Comments

From Bow Tie Is Really a Camera: “Re: EClinicalWorks interview. Will it lose a lot of customers following the Department of Justice settlement?” I highly doubt it. While various reports claim that a big chunk of ECW’s customers are considering mass defection, I don’t think that will ever happen since the incident doesn’t affect them personally. They either like the system or they don’t and the high-profile settlement doesn’t provide any new incentive to expensively rip-and-replace even though ECW is now on the hook to provide migration assistance should they choose to move to a new system. It’s not like painlessly boycotting a brand of soda by just reaching two shelves over for the nearly identical sugar water. In fact, the DOJ’s mandated company changes will probably make ECW’s software and support better. People subconsciously try to please a surveyor and to express indignation that they rarely act on. Customers might also appreciate the little-observed fact that ECW paid $155 million in settlement partly to protect them from having to individually repay their Meaningful Use incentives. I don’t think the settlement is going to have much effect on the somewhat stagnant ambulatory EHR market.

From Broken Tiller: “Re: the HIMSS-owned publication. How did they mistake Amazon’s healthcare projects as building an EHR?” There’s so much to dislike about this clickbait piece: the gratuitous “Wait! What?” plea for attention, calling Amazon’s rumored healthcare projects an “investigation,” and claiming in the headline that the companies are building EHRs when nothing in the CNBC article that they reworded into a lame story suggests any such thing .

From Weezy: “Re: Allscripts acquiring McKesson EIS. Why?” Good question. They bought it cheap, apparently, like day-old bread that the store is anxious to get rid of while it’s still sellable. I have to assume that the net present value of the EIS maintenance revenue stream will cover most of the acquisition price. I see no product synergy whatsoever and I seriously doubt that many Paragon, Star, or Series customers will have an interest in moving to Sunrise, just like users of the mothballed McKesson Horizon product – like the market in general — nearly universally passed on Paragon in favor of Epic and Cerner. Maybe the bottom line is that Allscripts just likes to acquire companies (Eclipsys, Misys, Jardogs, dbMotion, etc.) in hoping that it will either all come together or that investors will remain interested in a healthcare vendor that, like McKesson in years past, runs itself like a health IT mutual fund.

HIStalk Announcements and Requests

Listening: new from Alice Cooper, which has some pretty good tracks until things get even better in the final two songs, which feature the surviving members of the original Alice Cooper band, formed by the five Phoenix high school friends in the mid-1960s and named after a minor character in the “Mayberry RFD” TV series of that era. There’s also stunning new EP from Canada grungers Theory of a Deadman that brilliantly and savagely attacks our drug-happy culture. Finally, I’m enjoying outstanding old power pop from The Posies.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Medical imaging and data management vendor UltraLinq Healthcare acquires Northern Ireland-based Intelesens, which offers wearable vital signs monitoring devices.

Viome, which offers at-home kit that monitors  gut microorganisms to recommend diet changes, raises $15 million in a Series A funding round. Twice-yearly stool sampling and metabolic challenge tests cost $700 per year.

Aurora Behavioral Health signs a $20 million contract South Korea-based EZCareTech, which will create a US version of its hospital information system that is used by Seoul National University Hospital called Best Care 2.0B. They exhibited at HIMSS17, which I summarized as:

I was interested in Best Care, a Korea-based inpatient EHR whose monitors showed a cool-looking product that they are apparently trying to market to US hospitals. I tried to strike up a conversion with the stern guy standing there and he wouldn’t really talk to me. I tried again with another guy and all he said was that company is “from Korea, like K-pop” and then didn’t say anything else. I tried a third time in asking a different person on the other side of the booth if it was OK if a snapped a photo of the screen and they shooed me away. I think the company had best hire some US sales talent if they want to sell here.

Theranos settles the $140 million breach of contract lawsuit brought against it by Walgreens over its in-store Theranos lab sample drawing sites.

Sales

Cedar Valley Medical Specialists (IA) chooses EHR and population health solutions from EClinicalWorks.

People

Sutherland Healthcare hires Shailja Dixit, MD, MS, MPH (Intercept Pharmaceuticals) as chief medical officer and global head of digital innovation.

Health Systems Informatics hires Mary Beth Seaman (Pivot Point Consulting) as VP of business development.

Michael Jackman (GE Healthcare) joins imaging systems vendor Mach7 Technologies as CEO.

Announcements and Implementations

Caradigm integrates Insignia Health’s self-management survey into its Care Management solution.

Community Hospital Anderson (IN) goes live on Imprivata PatientSecure biometric patient verification.

Parallon Technology Solutions leads the migration of the two hospitals of Thomas Health (WV) to Meditech 6.15 from Meditech Magic and Siemens.

Government and Politics

A new CMS rule will allow hospitals to submit only one quarter’s worth of eCQM reporting requirements for incentive payments in 2018 vs. the previously required full year. It also allows hospitals to use either a combination of 2014 and 2015 Editions of CEHRT or either individual edition to satisfy 2018 eCQM certification requirements for CY 2018. CMS says it will determine requirements for CY 2019 and future years “in future rulemaking.”

The VA will expand its telemedicine program – the largest in the country — with VA Video Connect in a collaboration with Jared Kushner’s American Office of Innovation, offering virtual visits from 300 VA medical providers at 67 hospitals and clinics. President Trump said in a statement Thursday,

Today, I’m pleased to announce another historic breakthrough that will expand VA services to many more patients and veterans.  We will do this through telehealth services.  It’s what it’s called — telehealth services.  

We’re expanding the ability of veterans to connect with their VA healthcare team from anywhere using mobile application on the veteran’s own phone or the veteran’s own computer.  This will significantly expand access to care for our veterans, especially for those who need help in the area of mental health, which is a bigger and bigger request — and also in suicide prevention.  It will make a tremendous difference for the veterans in rural locations in particular.  

We’re launching the mobile app that will allow VA patients to schedule and change their appointments at VA facilities using their smartphones.  So this is something they were never able to do.  Technology has given us this advantage, but unfortunately we have not taken advantage of that until now.

CMS withdraws its plan to require hospital accreditors such as The Joint Commission to publicly list the problems they find and the steps being taken to fix them. CMS says federal laws prohibit it from disclosing inspection reports and fears such a requirement could be viewed as an attempt to circumvent the law.

Attorney General Jeff Sessions announces formation of a Department of Justice unit that will seek out opioid-related healthcare fraud by reviewing prescribing and dispensing data for suspicious patterns. The DOJ will also fund 12 assistant US attorneys for three years who will focus exclusively in investigating and prosecuting opioid-related healthcare fraud.

The GAO announces its 15 appointees to the HIT Advisory Committee that will make recommendations to ONC as established by the 21st Century Cures Act. The first five members listed were already appointed b HHS or as consumer advocates:

• Cynthia Fisher (entrepreneur)
• Anil Jain (IBM Watson Health)
• Steven Lane (Sutter Health)
• Steve Ready (Norton Healthcare)
• Patrick Soon-Shiong (NantHealth)
• Michael Adcock (University of Mississippi Medical Center)
• Christina Caraballo (Get Real Health)
• Tina Esposito (Advocate Health Care)
• Brad Gescheider (PatientsLikeMe)
• John Kansky (Indiana HIE)
• Kensaku Kawamoto (University of Utah Health)
• Denni McColm (Citizens Memorial Healthcare)
• Brett Oliver (Baptist Health)
• Terrence O’Malley (Massachusetts General Hospital)
• Carolyn Petersen (Mayo Clinic)
• Raj Ratwani (MedStar Health)
• Sasha TerMaat (Epic)
• Andrew Truscott (Accenture)
• Sheryl Turney (Anthem Blue Cross Blue Shield)
• Denise Webb (Marshfield Clinic Health System)

ONC announces a five-year plan to switch from its own custom EHR certification testing tools to industry-developed replacements.

Privacy and Security

A New York Health + Hospitals IT employee is arrested for using the hospital’s computer and network to download child pornography. Daniel Sherlock, 28, is on probation from a similar 2015 case in which he pleaded guilty. The conditions of that case prevented him from owning a computer, he told authorities, so he used his HHC one instead. He avoided registering as a sex offender in the previous case because his low IQ classified him as intellectually disabled, a situation that apparently did not prevent him from holding a $62,000 corporate account management job at HHC.

Other

A Politico report quoting a single source claims that Epic CEO Judy Faulkner told Vice-President Joe Biden at a private January 2017 Cancer Moonshot meeting, “Why do you want your medical records? They’re 1,000 pages, of which you understand 10,” to which Biden was reported to have responded, “None of your business. If I need to, I’ll find someone to explain them to me and, by the way, I will understand a lot more than you think I do.” The source was Greg Simon, now president of the Biden Cancer Initiative and a cancer survivor. Politico’s source material was apparently this video from Simon’s fireside chat at MedCity Converge conference this week in Philadelphia. I transcribed his full comments from the video:

I think everybody here is familiar with the problem with EHR companies, which is they’re billing systems, and yet we rely on them to track doctors’ visits, our treatments, our outcomes. But they’ve never been designed to be patient friendly. They’ve never been designed to be shared. They’ve never been designed to be interactive with other systems.

The EMR companies blame all that on their customers, the hospitals primarily, and large provider networks, and they have some guilt here as well. But the Cures act that passed in December requires data from electronic medical records to be shared in a digital, longitudinal way that can be used by patients.

When we had a meeting just before we left the White House with several EMR companies, hospitals, and others,  we had, as they say in the State Department, a candid exchange. The head of a company that won’t be named – Epic – said to Vice President Biden – I should have sold tickets to this part – “Why do you want your medical records? They’re 1,000 pages, of which you understand 10.” So Biden said what I knew he would say, “None of your business. If I want to nail them to the walls of my kitchen, that’s my business. I don’t have to understand 1,000 pages. I want my records. If I need to, I’ll find someone to explain them to me, and by the way, I’ll understand a lot more than you think I do because people with cancer and their families and their friends and themselves learn a lot. So don’t make assumptions.” And it went downhill from there …

How can I as patient make better use of my medical records than having them sit in my doctor’s office? … if your financial advisor says, “Why do you want your statement?” run to the nearest police station .. we did spend tens of billions of dollars to encourage people to buy their products and we made billionaires of the executives of these companies. They’ve had fun – now it’s our turn.

An Epic spokesperson sent me this response to the Politico article:

The recount of a portion of the January 2017 White House meeting is inaccurate and misleading. Vice President Joe Biden was consistently polite and positive to every person, including every vendor, in the meeting. Epic supports patients’ rights to access their entire record, something they have been able to do for decades. In the meeting, Judy raised an issue regarding the 21st Century Cures Act that would potentially require a patient’s EHR information be transmitted in a way that was “easy to understand.” She said that a requirement to translate EHR medical terminology into patient-friendly language could be a barrier to getting the medical record out to patients. Vice President Biden agreed, saying, “That’s actionable” and requested that one of his staff get the requirement fixed.

A fascinating Bloomberg article profiles the 20-something brothers from rural Ireland who started credit card processing Stripe and built it into a company worth $9 billion and made themselves billionaires. The company just announced a deal in which it will process some of Amazon’s transactions in its goal to “increase the GDP of the Internet” and expanding its product line to help businesses incorporate, pay workers, and detect fraud so that “two people in a garage [will have] the same infrastructure as a 100,000-person corporation.” The frugal brothers moved the company into San Francisco office space previously occupied by Dropbox, immediately getting rid of the Lego room, sofa swings, and gourmet meals cooked to order, explaining, “It’s slow and indulgent to wait for food.” One of the brothers keeps a countdown clock on the wall that estimates how much time he has left to live, explaining, “When you talk to people who are old, some wish they had enjoyed themselves more, but not many wish they had wasted more time … It’s not that I don’t enjoy TV. If I had infinite time, I would watch it. This might be the entirely wrong optimization.” It’s Atlas division offers a startup toolkit that provides Delaware incorporation, a bank account, a Stripe account, and both free and discounted professional advice.

Ireland’s Healh Services Executive warns physicians that a bug in its image archive omits the less than symbol (<), so that reviewing a result that lists stenosis as “<50 per cent” would be displayed as “50 per cent.” At least 25,000 images are affected. The HSE CIO resigned right after the story ran, but HSE says his departure is not related to the glitch.

Hurley Medical Center (MI) will identify patients with food insecurity via two EHR questions, with positive responses generating a referral to the hospital’s food pharmacy that will dispense a two-day supply of healthy food. The hospital hopes to provide assistance to its Flint patients who don’t necessarily live in poverty, but whose financial circumstances may require them to choose between buying medications and buying food.

In England, a Business Insider investigative article finds that Google-owned DeepMind has paid Moorfields Eye Hospital $144,000 in expense reimbursement in a project to apply artificial intelligence to optical coherence tomography scans, hoping to automate the early detection of diabetes-related macular degeneration. The hospital performs 3,000 of the tests each week.

Sponsor Updates

• ROI Healthcare Solutions is sponsoring the RocketShot 5K on August 12 in Roswell, GA. 
• Learn on Demand Systems CEO and Chief Product Architect Corey Hynes receives the Microsoft Most Valuable Professional Award.
• Inc. profiles Logicworks CEO Ken Ziegler.
• Forrester names Salesforce Health Cloud a leader in its latest report on enterprise health clouds.
• MedData and Experian Health will exhibit at the HFMA Region 8 – MidAmerican Summer Institute August 7-9 in Kansas City, MO.

Blog Posts

• Clinical Simulation Bolsters EHR Readiness (Optimum Healthcare IT)
• What data can reveal about the drivers of hospital readmissions (Nordic)
• 5 Common Myths about Patient Engagement Debunked (HealthLoop)
• Why Modern Hospitals Need Encrypted Paging (Spok)
• Five Things Health Systems Leaders Need to Know About Access Centers (Kyruus)
• Carbondale’s Cosmic Event: The Liaison Connection (Liaison Technologies)
• CMS Home Health Emergency Preparedness (LiveProcess)
• When it Comes to a Hospital’s Revenue Cycle, Cost is King (MedData)
• Empower Your Revenue Cycle Team with 3 Tips from the Summer Vacation Playbook (Navicure)
• Connecting Digitally – a Must for Care Collaboration (Netsmart)
• Are you doing these small things to build a great client relationship? (Nordic)
• Parallon Technology Solutions leads Thomas Health to Successful Meditech 6.15 Large Scale Implementation (Parallon Solutions)
• Healthcare Innovation Doesn’t Happen Overnight (PatientPing)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Allscripts Will Acquire McKesson’s EIS Business for $185 Million

Allscripts announced this afternoon that it will acquire McKesson’s Enterprise Information Solutions health IT business for $185 million in cash.

The products acquired include the Paragon EHR, Star, Series, Healthquest, Lab Analytics and Blood Bank, and OneContent.

Allscripts CEO Paul Black said in a statement, “Adding these assets to Allscripts existing portfolio enables us to better serve our clients, increase our scale and further drive our investment in innovation. This transaction is expected to directly benefit our existing clients and our shareholders, as well as the Enterprise Information Solutions clients and team members we’ll welcome to our family. Allscripts is a critical strategic partner to thousands of healthcare organizations and our highest priority is to successfully meet their highly complex needs of today and in the future, as we enable them to lead the change to smarter care. The healthcare IT market remains highly fragmented. Today’s announcement is a proactive and strategic measure to maintain Allscripts long-term leadership and position Allscripts for continued growth.”

Allscripts says it will continue to offer Paragon to small hospitals while continuing to sell Allscripts Sunrise to larger health systems.

News 8/2/17

Top News

Athenahealth — under pressure from activist investor Elliott Management — will undertake an operational review and says it has already identified $100 million in cost-saving opportunities.

The company will also hire a president and will recruit an independent board chair, removing both responsibilities from Jonathan Bush in leaving him with just the CEO title.

ATHN shares rose 5.6 percent Tuesday.

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor TriNetX. The Cambridge, MA-based company’s TriNetX Live health research network connects healthcare organizations, biopharma, and contract research organizations so they can collaborate, enhance trial design, accelerate recruitment, and bring new therapies to market faster. Members can analyze patient populations using search criteria across multiple longitudinal data points. Advanced analytics identify the most impactful criteria and the rate at which new patients present. Each de-identified data point can be traced to healthcare organizations that can then identify individual patients, allowing researchers to create virtual patient cohorts from real-world clinical trial settings. They can also find patients for studies and collaborate with peer research organizations. The network contains 84 million patients, 7.1 billion clinical facts, 3,554 protocols analyzed, and 757 trial requests, with all data de-identified to the user with all PHI remaining local. CEO Gadi Lachman is an industry long-timer, having held executive positions with TriZetto, Eliza, and American Well after he earned a law degree and a Harvard MBA and served as an officer in the Israeli Special Forces. Thanks to TriNetX for supporting HIStalk. 

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Meditech announces Q2 results: revenue down 3 percent, EPS $0.39 vs. $0.44. Both product and service revenue dropped slightly quarter over quarter.

Quality Systems (NextGen) announces Q1 results: revenue up 7 percent, adjusted EPS $0.17 vs. $0.15, beating analyst expectations for both. QSII shares rose 3 percent Tuesday.

From the Quality Systems earnings call:

• The company has received a Civil Investigative Demands letter from the Department of Justice. They’ve heard that other vendors have received similar letters, which are sent when the Attorney General believes that a person or company has material relevant to a false claims law investigation.
• President and CEO Rusty Frantz says NextGen isn’t seeing any increased market interest following the EClinicalWorks settlement with the Department of Justice, explaining that, “KLAS came out with a report that says a significant number of clients are looking to change, but if you read further down in that, only about 4 percent, according to them, were actually looking to change because of concerns with how they operated.”
• Frantz says his recent large-client user group meeting “was a little tough … we had some really unhappy clients out there” due to lengthy upgrades that the company is committed to improving.

Quality Systems will acquire analytics vendor EagleDream Health for $26 million in cash. The company has “a dozen or so” clients — none of them running NextGen — and generated a loss of $4 million on $1 million in revenue last year. It raised $1 million in a single funding round in May 2016.

Sales

Mercy Health Services (MD) will implement Bernoulli One to integrate perioperative suite anesthesia devices with Epic.

Vail Valley Medical Center (CO) chooses Spok Care Connect for secure mobile messaging, clinical alerting, emergency notification, physician on-call scheduling, and contact center efficiency.

Catholic Medical Center (NH) adds several Allscripts Sunrise products to its existing Acute Care, Critical Care, and Pharmacy modules including Ambulatory Care, Emergency Care, Surgical Care, Radiology, Financial Manager, Critical Care, and several others.

People

Roni Amiel (Frost Data Capital) joins Notal Vision as CIO.

OptimizeRX hires Miriam Paramore (Lucro) as president.

MD Anderson Cancer Center VP/CIO Chris Belmont announces that he will leave the organization.

Announcements and Implementations

Kootenai Health (ID) formally aligns with Providence Health & Services, with Kootenai’s CEO saying the biggest benefit is that his organization was already replacing Meditech with Epic, which will allow it to easily share information with Providence’s Epic system. 

Recondo Technology says bookings for its cloud-based RCM applications are up 72 percent, particularly for its Epic-integrated ClaimsStatusPlus system.

In the UK, Imperial College, Edinburgh University and Salford Royal NHS FT win the bid to run the virtual NHS Digital Academy, which will train 300 NHS digital leaders over the next three years in a year-long, part-time study program for CCIOs and CIOs in which Harvard Medical School will also participate.

Government and Politics

An interim report from the White House’s opioid crisis commission calls for the President to:

• Declare a national opioid emergency
• Eliminate Medicaid drug treatment limitations
• Require all DEA registrants to complete a pain management course
• Equip every police officer with fentanyl detection sensors as well as the opioid-reversing drug naloxone
• Provide technical support and funding to connect state prescription drug monitoring program databases to each other and to federal healthcare systems
• Remove the HIPAA limitation that prevents addiction treatment professionals from sharing information with other providers without written patient consent

An interesting Health Affairs blog post summarizes changing feelings about American healthcare, obtained by surveying the same panel of respondents every two years since the ACA’s passage in 2010. Some of its findings:

• Dissatisfaction rose from 45 percent to nearly 60 percent, mostly because Democrats largely failed to deliver on their promise to lower the cost of insurance premiums and healthcare services.
• Out-of-pocket costs and treatments that insurance doesn’t cover were big dissatisfiers.
• More than half of those polled think the ACA increased their taxes, which is probably not true since the high-income thresholds affect less than 2 percent of the population.
• More Americans prefer to improve ACA rather than repeal it.
• Even though few Republican respondents view the ACA favorably, its personal impact (such as coverage through age 26) is changing some of the party line perception.
• Americans aren’t disappointed with ACA coverage, but rather their lack of access to government coverage instead of private coverage. People of all political beliefs who are on Medicare, Medicaid, or a subsidy financed by the ACA are more satisfied with their insurance cost by a margin of 20 points.
• The study concludes, “Public opinion toward the ACA has been poorly understood because of an apparent contradiction. On the one hand, a growing share of the public harbor unfavorable views of the ACA as a whole, and proponents of repeal have seized on this dissatisfaction to claim a popular mandate. On the other hand, the discontent of Americans stemmed from disappointment with the ACA for not satisfying their expectations of genuine protection from the burden of costs. Far from wanting to be rid of the ACA, Americans are looking to it to deliver more effective protection.”

Lobbyists for physician groups and  insurance companies brag that a House-passed bill that would lower malpractice damage limits and limit attorney fees was nearly a word-for-word copy of what the lobbyists themselves drafted. Legal experts say it’s rare that a bill moves through a chamber without changes or public hearings and note that the bill was passed just four days after its introduction. The bill’s sponsor, Rep. Steve King (R-IA), acknowledges the industry’s involvement, but added, “I just don’t want to have to ride that horse again. Let’s get ‘er done.” 

The Senate’s HELP Committee will hold hearings in early September to craft a short-term plan to stabilize the individual insurance market, hoping to complete their work by mid-September when insurers make their final decisions on premium prices.

Privacy and Security

NIST and HHS OCR will co-host “Safeguarding Health Information: Building Assurance through HIPAA Security” September 5-6 in Washington, DC or via webcast. It seems strange that no food or beverages will be provided to in-person attendees and that webcast viewers pay nearly the same registration fee. It’s also ironic that webcast viewers are required to install Flash viewer, one of the most insecure software components on the web.

Innovation and Research

Inova Health (VA) will launch its Personalized Health Accelerator next month, offering chosen startups $75,000 in return for 10 percent equity and hoping to lead founders through a 4-5 month program that will enable them to attract outside investment and then apply matching Inova funds if they are successful. Those companies would then have access to Inova’s $100 million venture arm. The accelerator is looking for startups in predictive analytics, artificial intelligence, big data, and wearable devices. 

Other

A ranking of how well states are prepared for success in a data-driven economy places Massachusetts, Washington, Maryland, California, and Delaware at the top, with South Carolina, Alabama, Louisiana, West Virginia, and Mississippi rounding out the bottom 50. It’s perhaps unrelated that four of those five bottom-dwelling states (replacing South Carolina with Kentucky) have the highest obesity rates in the country, while Alabama, Louisiana, and Mississippi are also ranked among the five least-healthy states overall. They fare much better in college football rankings.

A JAMA research letter questions the high cost to physicians for earning and maintaining certification from the 24 members of the American Board of Member Specialties, which earn 88 percent of their swelling revenues from administering the exams, increasing their collective assets to $653 million. The study finds that doctors spend an average of $5,600 to take the exam — including the oral exam required by 14 of the boards — and then pay up to several hundred dollars each year to renew their certifications.

The local newspaper reports that the highest-paid hospital executives in Montreal, Canada are the fundraisers at McGill University Health Centre’s foundation, which ranks below average for donor accountability.

Sponsor Updates

• Optimum Healthcare IT completes its Level 1 call center support for the Epic go-live of Guthrie Clinic.
• Sphere3 offers a Gartner paper titled “Healthcare Moment: An Emergency Room Leverages The Real-Time Health System To Improve Efficiency.”
• Consulting Magazine recognizes Impact Advisors for the participation of its employees in a project that delivered 200 backpacks to patients at Florida Hospital for Children.
• Agfa Healthcare receives FDA clearance for Advanced Clinical Applications on the Xero Universal Viewer.
• Besler Consulting will exhibit at the HFMA Region 8 MidAmerica Summer Institute 2017 August 7-9 in Kansas City, MO.
• CoverMyMeds will exhibit at the Mediware Customer Conference August 7-9 in New Orleans.
• Glytec Chief Medical Officer Andrew Rhinehart, MD contributes to the American Diabetes Association’s new standards for diabetes self-management education.
• Healthwise will exhibit at Allscripts ACE 2017 August 8-10 in Chicago.

Blog Posts

• Three Key Steps to Maintaining Top-Notch Data Governance (Forward Health Group)
• 70 Companies Driving the Future of Healthcare Technology (Redox)
• Taking Approval Processes to School (Access)
• Are you READY to reinvent your EHR system? (Meditech)
• EHR vs. EMR: Differences Between Electronic Health Records Software (AdvancedMD)
• Summer Means MACRA/MIPS Fun (Aprima)
• What does it take to be a 100% HIPAA compliant cloud company? (Datica)
• Examining How Online Patient-Reported Outcomes Make a Difference in Cancer Care (Carevive Systems)
• Top 12 Strategies for a Successful Implementation – Part 2 (Casenet)
• You Only Fail When You Refuse to Try (CTG)
• Population health, then and now (EClinicalWorks)
• 5 Signs Your Pre-Registration Process Needs an Upgrade (FormFast)
• The Missing Link: Patient Responsibility for Health Records (Hayes Management Consulting)
• Healthcare Digital Transformation: What, Why & How (Part 1) (The HCI Group)
• Selecting Top Quality Hospitals for Maternal Care (Healthgrades)
• Preparing for cyberattacks: building a resilient infrastructure (Imprivata)
• Coach Your Healthcare Marketing Team to Consumer Experience Success (Influence Health)
• Time to Remove the Clutter (InterSystems)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 7/31/17

Top News

Mark Zuckerberg and Priscilla Chan, MD donate $10 million to launch UCSF’s Institute for Computational Health Sciences, which will perform analytics-powered drug discovery using a combined EHR dataset from all five UC system medical centers.

The institute is headed up by UCSF pediatrics professor Atul Butte, MD, PhD, who says, “This is among the richest and most diverse medical datasets in the world, much more than just a set of billing codes. Because the data come from our patients, the data are an incredible resource for UC hospitals to improve the quality of care we deliver throughout California.”  

The UCSF announcement describes the potential application of Butte’s “data recycling” project that will analyze existing data sets to gain new insights:

The results of his work can be surprising. By combing through databases, members of Butte’s lab have shown that it may be possible to combat liver cancer with a drug originally approved to kill parasitic worms. They recently developed another computational method that rapidly predicts what other drugs might treat cancer, again using readily accessible public databases.

These approaches may offer a more cost-effective way to discover drugs than conventional strategies. To bring these novel, computationally identified drug candidates into early clinical trials might require a few hundred thousand to $1 million, compared to the $10 million to $1 billion or more that a pharmaceutical company typically spends to bring a new drug fully to market.

But drug discovery is just one potential use of data, as both scientists and physicians acquire deeper computational sophistication. At medical centers like UCSF, electronic health records (EHRs) are increasingly being looked to for insights on how to improve the quality of care and to better understand disease. For example, UCSF physicians used the medical record system to institute a virtual glucose monitoring system that, over three years, reduced the proportion of patients who were hyperglycemic by nearly 40 percent.

Reader Comments

From UMMC_Breach: “Re: University of Mississippi Medical Center. Another breach. This time their Epic server was hacked, affecting 7,500 individuals.” HHS’s wall of shame says the breach, categorized as a “hacking/IT incident,” was reported three weeks ago. I haven’t seen details. UMMC paid $2.75 million a year ago to settle HIPAA violations related to theft of an unencrypted laptop and poor implementation of security policies and procedures. UPDATE: a UMMC source says it wasn’t Epic that was breached – it was a retired EHR from a facility UMMC acquired several years ago that was maintained by a third-party vendor who operated it on an isolated network. It was never running on UMMC’s network.

From Richard Head: “Re: must-read HIT blogger list. You are on it.” Thanks. I’m not too impressed by the list, which was put out by a publicity-seeking, vendor-produced magazine. The evaluator is the 24-year-old “senior editor” whose LinkedIn says she was working as a bar cook three years ago before landing a job in aviation publishing and finally meandering into healthcare a few months ago. She actually made a few good choices, but some of the sites appear dormant, don’t have anything interesting to say, or have resorted to running promotional articles written by paying vendors. I only read two of the sites listed — Politico Morning EHealth and John Halamka’s Life as a Healthcare CIO.

From Subdude: “Re: Epic’s hardline stance against hosting third-party systems with their new RHO offering. I’m surprised Epic since has many third-party dependencies, far from a full-service offering comparable to those of other vendors.” Subdude provided a list of systems that Epic won’t host, some of which are:

• PACS and coding
• Credit card processing
• Document management
• Supply chain systems
• Faxing
• Fetal monitoring
• Interface engine
• Lab instrument middleware
• Medical device integration systems
• Enterprise print management
• Single sign-on
• Telemedicine
• Speech recognition

From Vaporware?: “Re: Cerner’s DoD go-live at Oak Harbor. Zane Burke listed what went live in the conference call. What was missing: CommonWell, Cerner Network, or any kind of record exchange to the outside world. No connections Cerner to Cerner, to Athena, or to Carequality. The facility is literally on an island, but this is taking it a step too far.” I wouldn’t assume that failing to mention interoperability to a bunch of stock analysts means it’s not in place, but maybe someone in the know can elaborate further.

From Jade Warrior: “Re: provider. I would prefer that you not use that term – it’s demeaning to physicians.” Physicians tend to forget that they aren’t the only “providers,” which is why a more-inclusive term was needed to collectively refer to physicians, hospitals, nurse practitioners, physician assistants, podiatrists, and other non-MDs/DOs who see patients without over-the-shoulder supervision, prescribe medications, and bill for their services. I don’t even like the title “doctor” since physicians hijacked it from others who are equally entitled to use it, such as pharmacists, dentists, or nurses who have earned a PhD or DNP (in which case your nurse is a doctor). The proper response to someone who announces, “I’m a doctor” is, “In what field?” (or if you have a master’s degree, you could say, “Great, I’m a master.”) Maybe for individual providers (not hospitals) we should use the profession’s name to eliminate all confusion  – Physician Smith, Nurse Jones, Dentist Garcia. That still leaves the issue of someone who has earned the degree but didn’t obtain licensure or isn’t practicing, such as the late Monty Python co-founder Graham Chapman, MD or Argentinean revolutionary Che Guevara, MD.  

HIStalk Announcements and Requests

Cerner shares would be vastly preferred by poll respondents forced at gunpoint to choose one of those listed, with Athenahealth finishing a distance second. New poll to your right or here: how would you grade your largest local non-profit health system in terms of selflessly serving their communities and all patients who need their services? Vote and then click the poll’s Comments link to explain their score.

Welcome new HIStalk Platinum Sponsor InteliSys Health. The Las Vegas-based company offers RxStream, the first real-time prescription transparency platform. RxStream integrates into e-prescribing and EHR workflows to help doctors and patients make cost-effective prescription decisions based on real-time local pharmacy pricing of clinically equivalent drugs. It then offers prescription adherence alerts and reminders that are integrated into EHR workflow. Analytics power a feedback loop between prescriber and pharmacy that can prevent adverse events or avoidable encounters that are caused by non-adherence, also helping insurers understand the experience of their members with drug efficacy and outcomes as part of population health management beyond simple claims data. RxStream inventor and CEO Thomas Borzilleri saw firsthand as CEO of a pharmacy benefits manager that PBMs skim big percentages from prescription cost, driving their profits at the expense of not just patients, but also insurers and employers who lack access to the PBM’s opaque business practices and can’t tell whether a PBM is saving them money or actually increasing their cost. Thanks to InteliSys Health for supporting HIStalk.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

This Week in Health IT History

One year ago:

• ONC issues a $250,00 funding opportunity to create a cyber-threat information sharing service.
• CMS adds star ratings to its Hospital Compare website.
• A disclosed Apple patent shows that the company is interesting in allowing iPhone users connect with a doctor, send them their HealthKit-collected information, and initiate a telemedicine session.
• Theranos CEO Elizabeth Holmes does a Q&A address the American Association for Clinical Chemistry, which one pathologist said is like having “Al Capone come and talk about his novel accounting practices.”
• Advocate Health Care Network (IL) agrees to pay $5.55 million to settle HIPAA charges involving three 2013 breaches of its medical group.

Five years ago:

• Defense Secretary Leon Panetta advises a House committee that DoD-VA integration won’t be finished until at least 2017.
• McKesson in its earnings call expresses confidence in its Horizon-to-Paragon strategy and its satisfaction with RelayHealth’s market position.
• Cerner predicts in its earnings call that Epic will suffer from trying to upgrade from its MUMPS-based platform and calls out Epic’s weaknesses as physician solutions, analytics, population health management, and interoperability.
• Roper announces that it will acquire Sunquest Information Systems from its private equity owners for $1.42 billion.

Ten years ago:

• Partners HealthCare signs a contract for Siemens scheduling, decision support, document management, community access, and payer connectivity.
• Misys Healthcare CEO Vern Davenport hints at acquisitions but agrees with his boss Mike Lawrie that the company’s healthcare performance remains poor.
• A hospital pricing company CEO argues that ambulatory EHRs don’t make sense unless providers are paid fixed prices for quality, questioning whether, “If the entire country implemented EMRs overnight, would we see significant overall improvement in healthcare productivity, efficiency, quality, and customer service?”
• An Eclipsys shareholder sues present and past company officers who he claimed defrauded investors.
• Health Affairs publishes a post-mortem on the failed Santa Barbara Project that was led by David Brailer’s CareScience, which had been replaced by CHCF, Perot, and Medicity.

Weekly Anonymous Reader Question

Responses to last week’s question:

• LOUD TALKER!
• Conducts all calls on speaker phone in a small office. His loud voice echoes through the hallway. Yes, he could close his door, but why be considerate of others?
• Someone who when asked a question always responds by saying they’ve sent you the information you are asking for “a long time ago” BUT they’ve never sent anything. After a few rounds like that at meetings, I just resorted to follow up with, “OK, thank you. Please resend the email.” they always end up sending a NEW email. Another one: when you’re leading a productive, decisive meeting and someone literally wakes up halfway into it and asks a long-winded question regarding a topic discussed wayyy at the beginning of the meeting. I simply smile and ask them to refer to their notes. Last ones: missing signatures in email or no out-of office contact information.
• Two women in leadership who just talk endlessly in meetings, even though 95 percent of what is discussed is already known. Waste endless time to be sure to get the 5 percent across. They apparently cannot see glazed eyes and blank stares and realize that the important 5 percent was probably missed when attendees only hear the “Peanuts” teacher voice after five minutes of regurgitation.
• The person who annoys me the most is someone who acts supportive and professional, then puts me down to my boss.
• My boss, who uses all our one-on-one time talking about herself and her work issues.
• When on conference calls or even team calls, the constant questions. This is especially annoying when someone has already provided the answer or has asked the question previously. I also dislike anyone that constantly complains. My philosophy is that if you don’t like where you work, then save us all your misery and just go work someplace else.
• They know enough to be dangerous and as if they are engaged and knowledgeable, but really are not and should defer to their knowledge experts. Ultimately results in more work and effort for all to proceed based on erroneous information by someone trying to fake it until they make it.
• I am a weirdo who generally likes the open office. However, on a different team across the aisle from me (<15 feet away) sits maybe the most infuriating person I’ve ever worked with, and I give him this highly competitive award without ever having had a single conversation – he sings. He sings and whistles, and he does these things LOUDLY and REALLY BADLY, and it’ll just be snatches of a song: there will be silence, and then MEEEET ME IN ST LOUIE, MEET ME AAAT THE FAIR and then NOTHING, and then just when your brain has stopped anticipating more, it’ll come through again. It’s like water torture. It activates a deep, primal rage in me. And this was happening before I got here, and I have NO EARTHLY IDEA why his teammates allow it.
  As I typed this, he whistled for about five seconds. God help me with patience and a cube rearrangement soon.
• Interrupting!
• The fact he has to mansplain everything over and over again. Also doesn’t realize that we’re all different life (and work) doesn’t revolve around spreadsheets. Also, “Does that make sense?” all the time. “No, it doesn’t make sense. Why don’t you mansplain to me again?”
• I work in an office building for a health plan. We have two small office kitchens on our floor. People seem to be either mess-makers or cleaner-uppers. I fall into the latter category. Why is it that whoever spilled the coffee grounds on the counter or got water all over the place, or slightly missed the trash can with a tea bag wrapper can’t be bothered to clean up? We’re not talking about mopping the floors and waxing the microwave here. It’s just basic. This is a first-world problem, I know. And it’s in the annoying category. The last place I worked had nasty office politics with back-stabbing and lies being told routinely. That’s not annoying. That’s career-threatening. I’ll take the mess on the counter any day over that, but still …
• I’m a big proponent of “”teach a man to fish” vs. just answering the question du jour. I give someone the URL or email that tells them how-to or where to go for FAQ, etc. But it’s so frustrating when they keep coming back saying, “I know you told me xxxx. Can you send me that email again? I can’t find it?” or just asking the same darn question three months later. it’s so lazy and disrespectful when they clearly think my time is not as valuable as theirs.
• I was going to answer, but I started getting really irritated listing all the traits. I figured I’ll just read other responses and be glad I don’t have to deal with those.
• No follow through. Tasks are assigned, sort of completed, and left hanging. Somehow I end up completing whatever it is because it needs to be done, and it drives me insane. I’ve mentioned it several times and there was always some lame excuse.
• People who complain about how difficult their job is because of the many obstacles they face instead of just doing the work.
• He chooses to call me to discuss issues that can be detailed in a two-sentence email or a 60-second conversation. Those phone calls last 20 minutes minimum due to his ability to belabor the point or jibber-jabber and fail to get to the point. Waste of my time! I avoid his phone calls at all costs.
• The thought that everything can just change instantly and therefore little thought is given to major requests which means we are in state of constant chaos resulting in rework and duplication that misdirects valuable resources. Hoping that all talk and little action or deliverables catches up with this person soon.
• My narcissistic VP, who will say and do anything (except deliver) to look good without ever accepting accountability. It’s always some other person’s fault.
• Instead of trying to solve/configure solutions or workflows for customers, they whine about the “fact” people don’t know what they want. Then find whatever excuse they can to avoid helping.
• People who pretend they are doing work, but get nothing done; don’t work efficiently, and hold every one else up.  People who lie about the state of affairs and expect you to take the fall. Lack of integrity. Males who’s egos are way to big for their britches.
• Slow response time.
• They want to be, and think they are my good friend. Add to that quite a sense of self-importance.
• Flatulence.
• Chatterbox who spends conspicuous time at work socially, distracting by itself. Also complains loudly about difficult and complicated projects, so transferred out of associated roles to keep the peace. Yes, management is the core problem here, not the employee. 🙁
• She treats most people horribly, yells at those who report to her constantly, is known for her back stabbing, and keeps getting promoted. We share an office wall so I hear too many of her cringe-worthy conversations belittling people, either in her office or on the phone.
• Late to every. Single. Conference. Call. Always.
• IT executives who are technically clueless and weigh in on every issue in every meeting whether they know anything about it or not to try and impress the CIO.
• Not aligning priorities to team project deadlines. Other team members then are assigned additional takes late in the project and are frustrated while working to meet the deadline or work on overdue tasks.
• The person who puts their phone on speaker while in their cube because they don’t like the ”feel of a headset.”
• Changing deliverables and approaches the last minute.
• Anal-retentiveness and risk-avoidance in the extreme.

This week’s question: what life-summarizing phrase would you choose right now for your tombstone? Limit yourself to 15 words regardless of your wonderfulness level.

Last Week’s Most Interesting News

• The FDA announces a pilot certification program for digital health developers that will allow certified companies to get their products to market faster.
• HIMSS names Hal Wolf as its next president and CEO.
• A CNBC report says that Amazon’s 1492 healthcare skunkworks project is working on projects related to EHR data, telemedicine, and health applications for Echo.
• CHIME takes over the “Most Wired” survey.
• Nuance announces that its systems have not been fully restored nearly a month after its malware-caused outage, also warning investors of lower revenue and higher losses.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

From the Cerner earnings call:

• The company is almost finished with its succession planning in which a new CEO will be named to replace the late Neal Patterson.
• Q2 bookings were the highest in the company’s history at $1.636 billion.
• The company says it is competing well against Epic because of predictable total cost of ownership, contemporary architecture, return on investment, and its commitment to an open and interoperable platform.
• Cerner is scoping the work required for its VA project and negotiating a contract. It is also selecting partners, noting that unlike its DoD role, Cerner will be the prime contractor.
• Intermountain’s revenue cycle is finished in the Salt Lake City area and the company will replicate its experience across its client base.
• Zane Burke, asked about potential new non-traditional health IT competitors, said the core, transactional EMR is safe and that clients are more interested in getting data from it and Cerner’s open systems make that easy. He said, “I actually don’t think that those that are rumored to be doing things in this space are thinking about how they’re going to create the next EHR. They’re thinking about how can they add value into the whole entire healthcare supply chain and how can they think about making the consumer experience a better one because all of us are about to have a better patient experience at the end of the day.”

Decisions

• Banner University Medicine (AZ) will replace Epic with Cerner in October 2017.
• Kingman Regional Medical Center (AZ) will replace Siemens with Meditech in September 2018.
• AnMed Health Medical Center (SC) went live on Epic in June 2017.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.

Government and Politics

The US Supreme Court will hear oral arguments on October 2, 2017 in several cases involving mandatory class action waivers, one of them Epic’s. Epic — which was involved in previous class action lawsuits involving unpaid overtime — now requires employees to agree to arbitration instead of class action lawsuits for employment-related issues. The court will try to settle the conflicting decisions of lower courts in determining whether such agreements violate the National Labor Relations Act in preventing employees from acting together as  condition of employment.

Privacy and Security

A Roanoke, VA accountant’s office complains to the local newspaper about receiving frequent faxes from local hospitals, medical practices, and pharmacies after his fax number – which is similar to that of a physician’s office – was widely circulated. The accountant tries to do the right thing and let each sender know, but he gets PHI-containing faxes without cover sheets or spends up to an hour navigating phone trees and trying to reach the right person. He jokes that maybe he should just let the patients know directly since they have more clout with the provider involved. This is like most forms of healthcare data breaches – a provider that’s using poorly managed technology shoots the messenger for finding their mistake. Regardless of cover sheet legalese, the fax recipient is under no obligation to do favors for the the sender of the errant fax.

Other

Doctors in Canada express concern over Telus Health’s decision to display prescription drug coupons in their EHR workflow, paid for by brand name drug manufacturers to discourage the use of less-expensive generics. The doctors worry that patients will infer that brand name products are better and that patients may perceive a conflict of interesting. Telus Health says the coupons display only after the doctor has already chosen a specific brand name product and offers doctors the option to turn the feature off. The company has enabled the voucher in two of its seven EHRs – PS Suite and Nightingale – and will add it to the rest of them.

Nuance offers these comments from my interview with Charles Corfield, CEO of Nuance competitor NVoq:

• The NotPetya malware does not spread by email, by email attachments, or by infecting other files.
• No Nuance customer information has been altered, lost, or removed by the malware.
• We have no indication that any file contents on affected Nuance systems have been viewed by unauthorized parties.
• We have seen no evidence that ePHI files were encrypted in this incident since the types of files in which Nuance stores ePHI were not targeted by the malware.
• Unlike some malware, patching alone would not have stopped the propagation of NotPetya.

A Reaction Data survey of 200 HR and benefits leaders from providers, payers, and employers finds that while the majority of provider clinicians would like to see a single-payer health system, just about every body else hates the idea. Most respondents, however, favor universal healthcare that guarantees coverage but with both public and private participation. In fact, respondents seem to fear the federal government’s involvement most, with one benefits manager saying that “government intervention is the cancer” and that the free market should rule, while another observes that “we are the only developed nation on the planet to fail to recognize access to healthcare as a right – is that what we want as our legacy?” Respondents seem to miss the same significant point as their elected officials – the biggest problem involves high costs and provider-driven overutilization that enrich hospitals, doctors, insurance companies, and drug and device manufacturers at the expense of patients and taxpayers. We all foot that bill in one way or another.

In Indiana, a cancer patient’s pain management doctor declines to write her an opiate prescription after explaining that he doesn’t think narcotics would be a good choice for her chronic pain, after which the woman’s husband returns to the doctor’s office, shoots the doctor dead, and then kills himself.

The president and COO of Women & Infants Hospital (RI) quits due to its pending acquisition by Partners HealthCare and financial losses caused by declining birth rates and reduced NICU usage due to healthier babies.

Here’s Vince Ciotti’s review of Cerner’s history from awhile back.

My weekly “this week in healthcare IT history” items inspired Vince to look even further back with a monthly contribution from his stack of old magazines (he must be an HIT hoarder) that will describe the big news items 30 years ago and the lessons we might learn from them. He is also interested in hearing from his fellow pioneers at vciotti@hispros.com. I got wrapped up in his complete, 100-plus episode HIS-tory series that he created for HIStalk years ago – the people, products, and companies he covers are fascinating.

Sponsor Updates

• QuadraMed, a Harris Healthcare company, will exhibit at the GHIMA Annual Convention & Exhibit August 6 in Savannah. GA.
• The Solutionreach Patient Relationship Management Platform joins the Allscripts Developer Program.
• Diameter Health publishes an explainer video titled “Healthcare IT Hero.”
• EClinicalWorks says 1,000 providers selected its EHR in June, its strongest month so far this year.
• Sunquest Information Systems will exhibit at AACC Annual Scientific Meeting & Clinical Lab Expo August 1-3 in San Diego.
• ZappRx makes it to the final round of BostInno’s Coolest Companies competition.

Blog Posts

• 7 Quick Ways to Improve the User Experience of a Home Page (Salesforce)
• Improving Hospital Claim Collection Rates (The SSI Group)
• Patient Referrals: 7 Quick and Easy Ways to Fill Your Schedule (Solutionreach)
• Think inside the box on FWA: introducing the provider decision quadrant (Verscend Technologies)
• Johns Hopkins study uses Versus RTLS to monitor patient ambulation (Versus Technology)
• 3 ways Spectrum Health boosted virtual visit volume by 183% (Advisory Board)
• Can you? Visage can: Interoperability (Visage Imaging)
• 3 ways to prepare for CMS’s imaging appropriate use criteria (Meditech)
• Top healthcare communication experts to speak at VUE17. (Voalte)
• ICare Partnership Extends Evidence-based Content to Post-Acute Care Providers (Zynx Health)
  

  ---

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

News 7/28/17

Top News

FDA announces its “Pre-Cert for Software” program that will certify digital health developers (instead of their individual products) for fast tracking to market.

Up to nine self-nominated companies that are working on software that meets the definition of a medical device will be chosen for the pilot.

FDA Commissioner Scott Gottlieb, MD says in a blog post:

The goal of our new approach is for FDA to, after reviewing systems for software design, validation and maintenance, determine whether the company meets the necessary quality standards and pre-certify the company. Pre-certified companies could submit less information to us than is currently required before marketing a new digital health tool. In some cases, pre-certified companies could not submit a premarket submission at all. In those cases, the pre-certified company could launch a new product and immediately begin post-market data collection. Pre-certified digital health companies could take advantage of this approach for certain lower-risk devices by demonstrating that the underlying software and internal processes are sufficiently reliable. The post-market data could help FDA assure that the new product remains safe and effective as well as supports new uses.

FDA also announces in its Digital Health Innovation Action Plan that it will hire more staff for the digital health unit of its Center for Devices and Radiological Health. It will also launch an Entrepreneurs in Residence program in the next few months.

Reader Comments

From Vera Gemini: “Re: Mediware. Bill Miller, former CEO of OptumInsight, is taking over from Kelly Mann as CEO.” Verified. Miller left OptumInsight in an April 2017 executive shuffle. Private equity firm Thoma Bravo sold Mediware to another PE firm, TPG Capital, in February 2017. Mann was hired as CEO in September 2007 following his 24-year career as SVP of marketing operations for 3M Health Information Systems.

From MDRX ACE Sponsor: “Re: Allscripts ACE user meeting in Chicago August 8-10. They don’t have the usual big party scheduled for the second evening, which has been a staple for the last dozen years with big acts. I’m curious if anyone knows why this was changed – financials, liability, McCormick Place issues?” The agenda lists ACE Fest for Day 3, although it’s running from 4:30 to 6:30 p.m., timing that sounds more like happy hour. 

From Health IT Watchdog: “Re: Politico’s article showing that big, tax-exempt health systems are profiting wildly post-ACA. That certainly puts Epic’s ‘more margin, more mission’ to bed. If it wasn’t already clear, your EMR is not driving the profitability of your health system. Epic’s largest clients show revenue up, charity care down – that’s one way to drive your margins.”

From The PACS Designer: “Re: Java 9 release. July 27 marks the release of the much-anticipated Java 9 by Oracle. Its many new features are expected to excite the software industry, so it will be interesting to see if healthcare is a field that can gain from deploying Java 9.”

HIStalk Announcements and Requests

A reader who wishes to remain anonymous donated $50 to my DonorsChoose project, which actually fully funded a $200 project thanks to a $50 match from my anonymous vendor executive and then a $100 match from State Farm. Ms. L’s first grade class in Texas will receive math manipulatives as a result.

Listening: new melodic metal from Finland-based Nicumo. I’m also digging deep into musical history in enjoying Crack the Sky, which has been playing commercially unsuccessful progressive rock (kind of Steely Dan-ish at times) since forming in the early 1970s in Weirton, WV and making no splash at all other than developing a small following in the Baltimore area. There’s also the amazing 1981 Buck Dharma guitar solo I ran across in live video from the underappreciated, low-cowbell Blue Öyster Cult’s “Veteran of the Psychic Wars.”

This week on HIStalk Practice: Commonwealth Primary Care ACO taps Sonora Quest Laboratories for testing, analytics. Orthopaedic Associates of Michigan enlists Code Technology for patient-reported outcomes program. Idaho and Utah connect HIEs. Patients place physician experience above all else in satisfaction surveys. Legislators launch the Medicare Red Tape Relief Project. ATI Physical Therapy develops patient-facing, portal-friendly app. McKesson Specialty Health’s Calvin Chock offers guiding principles for designing a useful healthcare mobile app. Privia Health grows like gangbusters in Georgia. Rehab therapists cite documentation as their biggest challenge.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Cerner reports Q2 results: revenue up 6 percent adjusted EPS $0.61 vs. $0.58, meeting earnings expectations but falling just short on revenue.

McKesson reports Q1 results: revenue up 3 percent, adjusted EPS $2.46 vs. $3.15, missing analyst expectations for both. Shares dropped slightly in after-hours trading and have shed 18 percent in the past year.

Amazon is running a Seattle-based healthcare skunkworks project called 1492 that is working on several projects, according to a CNBC report:

• Sending and receiving EHR information
• Developing a telemedicine platform
• Working on health-related applications for Amazon Echo and Dash Wand.

Heading up the 1492 team are Kristen Helton, PhD (above) — a bioengineer who co-founded body sensing technology vendor Profusa –and Cameron Charles, PhD, an electrical engineer whose background is body-worn consumer electronics. The 1492 group listed several open positions that were apparently removed once the article made the project’s existence widely known.

Sales

RCCH HealthCare Partners (TN) chooses Summit Healthcare’s Exchange interface engine and migration services for its 17 regional health systems in 13 states.

People

HIMSS names Hal Wolf as its new president and CEO, replacing the retiring Steve Lieber. His background is quite different than that of Lieber, who spent his career as an association executive. Wolf comes from a vendor (The Chartis Group),  but has also worked at Kaiser Permanente in IT and operational leadership roles. For those who know him, care to speculate how he will change the HIMSS agenda? Particularly since EVPs John Hoyt and Norris Orms announced their retirement in February 2016 (although both are working elsewhere), leaving Carla Smith as the only long-time senior executive.

Drew Madden (Nordic) joins newly formed consulting firm Evergreen Healthcare Partners as a co-founder and managing partner.

Tom Schultz (HealthStream) joins Evariant as chief growth officer.

Carex Consulting Group hires Casey Liakos (Huron Consulting Group ) as president.

Victor Arnold (Huron Consulting Group) joins University of Missouri-Columbia as executive director of University Physicians and associate dean of the school of medicine.

Announcements and Implementations

Four-bed Southern Inyo Hospital (CA) goes live on Medsphere’s OpenVista Cloud.

Government and Politics

HHS OIG creates a video describing the $155 million Department of Justice settlement with EClinicalWorks, saying that the first settlement with an EHR vendor means “we’re entering an entirely new area of healthcare fraud .. we take the certification process for EHR software very seriously … OIG will investigate any conduct that places patient safety at risk and that causes losses to the federal healthcare programs.”

Technology

Adobe will retire its perpetually buggy, security-challenged Flash graphics package at the end of 2020 as open web technologies such as HTML5 have largely replaced it. Steve Jobs basically killed Flash in declining to support it on Apple’s mobile devices because it is: (a) proprietary; (b) unnecessary given the H.264 video format; (c) the number one reason Macs crash; (d) a poor performer on mobile devices; (e) a battery hog; (f) incapable of supporting touch-based interfaces; and (g) pushed on developers by Adobe to write cross-platform apps even though Adobe is slow to adopt OS enhancements.

Microsoft’s Asia research group develops a usable prototype of Path Guide, an Android app that provides low-cost, plug-and-play navigation services for inside buildings without relying on the phone’s GPS satellite connection or requiring building infrastructure. A “guide” starts the app’s recording function and then walks to the destination to create a “trace”  that others can follow in real time as they walk. The guide can add photos, video, or voice recordings to explain further. This could be an amazing benefit to patients and families trying to navigate around illogically laid out hospitals.

Other

Erie County Medical Center (NY) has spent $10 million to recover from its April ransomware attacked, half of the money spent on computer hardware and software and the remainder attributed to overtime pay and lost revenue. The hospital says it was lucky to have beefed up its cyber insurance coverage from $2 million to $10 million a few months before the attack that took 6,000 of its computers down. ECMC says the hacker applied a brute force password attack to gain access to an incorrectly configured web server that was secured by an easy-to-guess password.

The local paper covers the 200-employee virtual hospital of CHI Franciscan Health (WA).

In Ireland, a review finds that 21 infants experienced care delays because their referrals were sent by fax, which is the standard method of 80 percent of hospitals there vs. those 20 percent that have switched to electronic referrals.

Twitter shares dropped sharply Thursday after the company announced that its global user count was unchanged in the most recent quarter as its US user count actually declined. Twitter says it will focus on trying to get people to use its platform every day to increase its attractiveness to advertisers.

NextGen Healthcare clarifies via a LinkedIn post that the HIStalk reader-reported rumor about hard-coded passwords in Medhost’s Connex – which is based on NextGen’s Mirth Connect – is not a problem with the Mirth Connect product itself but rather Medhost’s distribution of a forked version of the open source product.

Baltimore Ravens offensive lineman John Urschel retires – apparently after reading new studies about football-caused brain damage – and will pursue a PhD in mathematics at MIT. He has a Penn State bachelor’s and master’s in math and has published several journal articles, including “A Cascadic Multigrid Algorithm for Computing the Fiedler Vector of Graph Laplacians.”

Sponsor Updates

• The local paper highlights LogicStream Health in its look at Minnesota venture capital funding in the first half of 2017.
• LogicWorks CEO Kenneth Ziegler discusses AWS growth on the Cheddar Network.
• Nordic opens a 6,000 square foot expansion of its Madison, WI office.
• Meditech is recognized as a healthcare innovator in the latest “Best of Canada” report.
• Emmem Ekorikoh of Obix Perinatal Data Systems, developed by Clinical Computer Systems, joins the board of Black Diamond Charities.
• CloudWave joins the Cloud28+ global community of independent cloud service providers.
• ECG Management Consultants publishes a new white paper, “ASCs at a Tipping Point: The New Reality of Surgical Services for Health Systems.”
• FormFast publishes a new white paper, “Connecting Patients & Providers Through Document Workflow.”
• GE Healthcare names Catherine Estrampes president and CEO of GE Healthcare Europe.
• Healthgrades announces its 2017 Women’s Care Award recipients, and publishes a related report on how hospitals can provide optimal maternal care.
• InterSystems will exhibit at AACC’s Annual Scientific Meeting & Clinical Lab Expo July 31-August 4 in San Diego.

Blog Posts

• Advancing Access to Image Exams Helps Pediatricians Administer Critical Treatment (LifeImage)
• Uniting to Take Great Care of Your Patients (MedData)
• How to reduce burnout with a physician driven EHR design (Meditech)
• MACRA, a qCDSM and the Value-based Payment Modifier (National Decision Support Company)
• House Bill Proposes Pilot Program with Incentives for Use of EHRs and Care Coordination (Netsmart)
• How to nurture your passion project while you consult (Nordic)
• Rethinking the Approach to Care Transitions (PatientPing)
• Poor Communication is Still Endangering Patient Safety (PatientSafe Solutions)
• Patient-focused Finance Trends at 2017 HFMA ANI (Patientco)
• It is Better to Give … (PatientKeeper)
• How Can Population Health Management Align with Bundled Payment Models? (ECG Management Consultants)
• How Messenger Sustains Community Practice (EClinicalWorks)
• Leveraging Your Epic System in the 3 Revenue Cycle Streams (Hayes Management Consulting)
• 5-Step Epic Optimization Program (The HCI Group)
• How inefficient communication technologies slow down providers and jeopardize patient safety (Imprivata)
• Why Mobile Matters for Your Hospital Website (Influence Health)
• The Expensive Reality of Short-Changing Security and Compliance in Healthcare (InstaMed)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

News 7/26/17

Top News

Hospital shares dropped sharply Tuesday after the Senate voted to proceed with its debate over the future of the Affordable Care Act. The voting was a 50-50 split, requiring Vice President Pence to cast the tie-breaking vote after all Senate Democrats and two Senate Republicans voted no.

President Trump commented in a news conference, “”I’m very happy to announce that with zero of the Democrats’ votes, the motion to proceed on healthcare has moved past and now we move forward toward truly great healthcare for the American people. We look forward to that. This was a big step … We had two Republicans that went against us, which is very sad, I think. It’s very, very sad — for them. But I’m very, very happy with the result. I believe now we will, over the next week or two, come up with a plan that’s going to be really, really wonderful for the American people.”

Reader Comments

From HealthInfoSecGuy: “Re: Medhost. A new vulnerability was disclosed. Looks bad. Different than surgery solution (PIMS) vulnerability disclosed last year. Looks like they have more hard-coded passwords in their applications. This time it is with their proprietary Mirth-based interface engine Connex. Not a good time for this to come out with the possible private equity sell-out. Vendor wasn’t responsive from the report and no patches available today. When will vendors stop this poor practice? Shows lack of enforcement for Meaningful Use attestation and security requirements. eCW, anyone?” The online report came from someone who appears to be knowledgeable of the problem, but who didn’t provide their credentials.

From Nitpicker: “Re: time zones. Why rant when everyone knows what I mean when I say EST instead of the technically correct EDT?” “Technically correct” is the same as “not wrong.” It annoys me that people are so self-indulgently lazy that they don’t care about making public mistakes, such as misstated time zones, misspelling, poor writing, and sloppy grammar and punctuation. That sends the indignant message that their time is more valuable than ours and we’ll just have to figure it out. I’m also noting an increased number of messages — many of them in Yelp and Tripadvisor reviews — that are full of wild misspellings and incorrectly used words because the author (or speaker, in this case) can’t muster the energy to correct mistakes caused by their phone’s voice-to-text feature.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Continuous ambulatory monitoring technology vendor PhysIQ raises $8 million in a Series B funding round, increasing its total to $19.9 million. The company, whose founder licensed the industrial monitoring technology he developed and sold to GE in 2011, will launch commercially later this year with patient monitoring contracts with two drug companies and two medical device vendors. 

CHIME and the American Hospital Association will take over the “Most Wired” survey. Hospitals & Health Networks magazine, which has been doing the survey with sponsor AHA, wasn’t mentioned in the announcement. Perhaps an early action item would be to correct the puzzling spelling of “HealthCare.” One might also argue that it’s not what you have but rather how you use it – find out what health systems with better outcomes at a lower cost are doing.

Circulation, whose system gives patients and providers access to Uber and other ride-sharing services for non-emergency transportation, raises $10.5 million in a Series A round.

San Francisco-based Hinge Health — which offers employers a wearable-powered app and remote exercise coaching for their employees with back and shoulder pain — raises $8 million in a Series A round.

Maven raises $10.8 million in a Series A round, increasing its total to $15 million. Its female-specific services include video visits and messaging with doctors, nutritionists, midwives, and other professionals.

Private equity firm KKR will acquire WebMD Health Group for $2.8 billion and will fold it into its Internet Brands media division. The Medscape medical news and education site takes in 60 percent of WebMD’s advertising revenue. 

Deaconess Health System (IN)  will integrate the state’s prescription drug monitoring program database with its EHR using Appriss Health’s PMP Gateway.

Sales

Meritus Health (MD) chooses Epic in a $100 million implementation project.

Beth Israel Deaconess Medical Center (MA) will use post-acute care patient placement software from The Right Place.

The Bermudas Hospital Board chooses Spok Care Connect for enterprise healthcare communications that includes on-call scheduling, a Web directory, secure messaging, emergency notification, and paging. 

People

Sphere3 hires Kathleen Harmon, MS, RN (Burwood Group) as chief nurse executive. 

Wes Champion (Premier) joins Kaufman Hall as managing director/COO.

Parkland Center for Clinical Innovation (TX) hires Vikas Chowdhry (Epic) as VP of data science.

VortexT Analytics hires Dick Hull (Hospital IQ) as president/COO.

Samuel Allen Hamood (TransUnion) joins Change Healthcare as EVP/CFO. He replaces the retiring Randy Giles.

Randy McCleese (St. Claire Regional Medical Center) joins Methodist Hospital (KY) as CIO.

Outcome Health promotes Vivek Kundra to COO.

Announcements and Implementations

Allscripts will offer Conversa’s Conversation Platform as the patient-facing portion of its CareInMotion population health management platform to engage patients between visits. Allscripts will also make an unspecified investment in Conversa.

Konica Minolta integrates document sharing technology from Kno2 into its multi-function printer control panel to help transition healthcare customers from faxing to secure data exchange.

Surescripts adds 14 health systems to its National Record Locator Service, raising the total to 41 health systems that are using NRLS or preparing to go live on it.

Boston Software Systems publishes an explainer video on using in-house rather than outsourced expertise to optimize time-consuming hospital tasks using its Cognauto rules-based workflow automation platform.

Helix, a spinoff of big DNA sequencer Illumina, opens up its sequencing technology to consumers who can gain access to a lifetime of genetic insights from a single saliva sample at a cost of $80. Helix’s marketplace allows buying apps and analysis from third parties whose cost might explain why the initial test runs just $80. It’s also unknown what actionable insight healthy people might gain from the information. Providers such as Geisinger and Mayo Clinic will offer genomics services, while other companies offer less-serious products such as a DNA-powered wine chooser and a scarf featuring the wearer’s genomic pattern. 

Aprima will integrate Patient IP’s clinical trials patient matching platform into its EHR.

Dignity Health will extend its use of Docent Health’s patient experience platform to Dignity Health Bakersfield Memorial Hospital.

Cleveland Clinic and CVS Health expand their eight-year affiliation offer medication counseling, chronic disease monitoring, and wellness programs at CVS Pharmacy and MinuteClinic locations on Northeast Ohio and Florida. CVS Health has also joined Cleveland Clinic’s Quality Alliance clinically integrated network.

Government and Politics

HHS revises its online HIPAA Reporting Breach Tool with improved navigation.

Ohio’s healthcare price transparency law that requires providers to give patients a good-faith cost estimate for non-emergency services didn’t go into effect January 1, 2017 as scheduled after heavy lobbying and legal actions by the Ohio Hospital Association and provider professor organizations. They claim that giving patients estimates would slow down patient care.

Other

A Yale study and New York Times report finds that many surprise ED bills – caused hospitals outsourcing their ED coverage to out-of-network companies — come from ED staffing company EmCare, which is owned by publicly traded Envision Healthcare. It notes that at one small, rural hospital, visits that were billed using the highest-level billing codes jumped from 6 percent to 28 percent after EmCare took over, with the resulting patient complaints forcing the hospital to go back to its own coding and billing. The company also has a pending case from 2011 in which a whistleblower alleges that EmCare and Health Management Associates hospitals pressured ED doctors to do medically unnecessary procedures and tests and fired doctors who pushed back. EmCare is buying anesthesiology and radiology practices, which like EDs, do not allow patients to choose in-network doctors and instead leave them holding the full, more profitable bill that their insurance won’t pay.

High school graduate Gwyneth Paltrow – who via her “modern lifestyle brand” Goop empire out-hucksters Dr. Oz with even less attention to science in confusing her personal beliefs with known medical facts – gets called out by Jen Gunter, MD for suggesting that women place a crystal in their vaginas for pelvic floor strengthening and then suggesting that Dr. Jen is a “third party” who is “strangely confident” in labeling that idea as crazy:

I was blogging about pseudoscience long before Paltrow first squatted over a pot of steaming allergens and leveraged her celebrity to draw attention to her website … I am not strangely confident about vaginal health, I am appropriately confident because I am the expert. I did four years of medical school, a five-year OB/GYN residency, a one-year fellowship in infectious diseases, I am board certified in OB/GYN in two countries, I am board certified by the American Board of Pain Medicine and the American Board of Physical Medicine and Rehabilitation in Pain Medicine and I am appropriately styled Dr. Jen Gunter MD, FRCS(C), FACOG, DABPM, ABPM (pain). A woman with no medical training who tells women to walk around with a jade egg in their vaginas all day, a jade egg that they can recharge with the energy of the moon no less, is the strangely confident one.

An articles describes the 20-year health tech venture capital deals database created by Correlation Ventures, whose predictive analytics algorithm then scores a possible investment using CEO credentials, scientific validity, and the track record of previous investors to give it an invest-or-pass decision in two weeks. The firm says the algorithm rules out 90 percent of potential investments, but doesn’t say how the chosen investments have performed.

An interesting study tweeted out by Eric Topol finds that money really can buy happiness if you spend it on time-saving services. One of the studies it reviewed found that doctors who were give vouchers for such services reported better work-life balance.

A KQED article covers EHR usability issues that frustrate doctors and eat up their face-to-face time with patients. The article quotes doctors who blame the EHR for their inefficiency and burnout, but it also includes a wise quote from Redwood MedNet project manager Will Ross: “Documentation is still there, so blaming the computer for what insurers and the government are requiring you to do is misplacing the blame.”

Sponsor Updates

• InteliSys Health is named a finalist in a publication’s healthcare innovation award for its RxStream prescription transparency pricing platform.
• Kyruus will host its Thought Leadership on Access Symposium in Boston September 19-20.
• Ability Network earns accreditation from EHNAC’s Cloud-Enabled Accreditation Program.
• Princess Elizabeth Hospital in the UK selects Agfa Healthcare’s direct radiography system.
• Frost & Sullivan recognizes EClinicalWorks with the 2017 North American Frost & Sullivan Award for customer value leadership.
• Diameter Health, in partnership with Kammco Health Solutions, receives NCQA certification for 21 electronic clinical quality measures for 2017.
• Besler Consulting releases a new podcast, “Clinical Documentation in CJR.”
• CompuGroup Medical will exhibit at AACC July 30-August 3 in San Diego.
• Glytec’s Robby Booth discusses the importance of data-sharing capabilities on AJMC TV.
• Liaison Technologies will exhibit at the AHA Leadership Summit July 27-29 in San Diego.
• Diameter Health President and CTO John D’Amore co-authors a study on the implantation of a clinical decision support risk prediction tool for chronic kidney disease.

Blog Posts

• Pro-Active EHR Optimization is a Necessity (Optimum Healthcare IT)
• Channeling Dr. Phil: Improve the Relationship Between IT and Operations Teams (Impact Advisors)
• The Art of Doing the Right Thing (Access)
• Chronic Care Management in 2017: Where Are We Today? (CareSync)
• You Only Fail When You Refuse to Try (CTG)
• 7 Hot IT Outsourcing Trends – and 7 Going Cold (Direct Consulting Associates)
• How to Best Support Your Salespeople (Dimensional Insight)
• The Quadruple Aim (Spok)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

Monday Morning Update 7/24/17

Top News

A Nuance investor disclosure announcement on Friday says the company has not yet fully restored all of its cloud-based systems that went offline in a June 27 malware attack.

Nuance warns that its financial results for Q3 – of which the malware incident impacted only the final week – will suffer, with expected revenue of $485-489 million instead of the previously estimated $500-$504 million. The company expects to lose $0.11 to $0.09 per share in the quarter instead of its previously estimated loss of $0.07 to $0..05. The Q3 results will be posted on August 8.

Nuance says its Q4 results will also be negatively impacted from the outage, mostly related to its HIM transcription services business.

Nuance added that it hopes to restore services within two weeks to all customers of its EScription LH back-end transcription system for large hospitals.

Shares of Nuance Communications fell briefly in pre-market trading following Friday morning’s announcement, but closed up 2 percent. They’re up 6.5 percent in the past year but down 18 percent in the past five.

One might speculate that it’s going to be a rough Q4 for Nuance if just one week of Q3 downtime whacked $15 million off the company’s quarterly revenue — the outage on some significant systems has extended three weeks into Q4 and won’t be fully resolved for at least two more weeks.

Reader Comments

From Firm Mattress: “Re: your HIT index. I took the liberty of scoring the top 10 of last year’s #HIT100. The low scores seem about right to me.” My scoring method tries to quantify how I assess someone’s healthcare credibility from their LinkedIn profile in looking at healthcare-specific education and accomplishments. I place zero value on social media influence. Twitter is a great way to showcase someone’s deep knowledge and thoughtful opinions (I’m thinking of people like Andy Slavitt and Eric Topol), but it’s also a medium embraced by those with few other accomplishments or possessing light credentials for rendering opinions on complex topics who just retweet stuff other people came up with. My problem with the HIT100 and similar recognition is that some people desperately seek it as validation in the absence of other achievements and brag about winning like it actually means something. To which I would ask in rudely re-introducing the real world into the discussion: how many of Modern Healthcare’s “100 most influential people in healthcare” have followed you, retweeted you, contacted you personally, or offered you a job? You earn cool points, however, for being on the list without ever having mentioned it in pandering for votes or bragging on being named. Feel free to poke holes in my scoring method or the reader’s application of it above. I’m tempted to assign points for military service, particularly in a healthcare or leadership role, since I value that pretty highly in someone’s bio.

My final thought about self-confidence vs. knowledge and experience applies to all of us  — I’m uncomfortably aware of how well this describes me at times.

From Aphasian: “Re: HIMSS conference. We need a good marketing idea that will generate buzz in Las Vegas.” Obtain a picketing permit from the city and hire pamphlet-passing shills to carry protest signs on the public sidewalk  –your “protest” should involve your product or service.

HIStalk Announcements and Requests

Poll respondents say the only industry awards that are significant are KLAS and the Davies, but even then, “none of the above” wins the grand prize. Reader Dewey, Cheatham & Howe looks at methodology: “Most Wired is an online form. Completing the form is labor intensive, but not difficult or vetted. If people can (and do) lie about their MU attestations, then what do you think you are getting with Most Wired? KLAS has skilled interviewers and they try to remove bias, but it is easily gamed. HIMSS EMRAM Stage 6 uses same methodology as Most Wired — little to no validation. HIMSS Stage 7 is different because it requires a site visit by experienced surveyors. HIMSS Davies requires a write-up with validation. As for the rest, I assume they are conducted with little or no pre-survey modeling of measurement criteria or post survey review of bias.”

I’ve overseen several “Most Wired” wins in the health systems I’ve worked for, but a comment from the cynical manager I assigned to complete our entry one year best summed up the form’s self-attesting ambiguity: “It’s not what we actually do, it’s how badly you want us to win.” Nobody in IT thought the Most Wired award meant anything at all since the responses allow wiggle room and our job was to support the health system instead of worrying about pointless awards, but we did feel some responsibility after the first win to keep applying. Nobody wants to be the health system that falls off the list – even voluntarily – from one year to the next. Organizations give awards and recipients proudly accept them for entirely self-serving reasons.

New poll to your right or here: which company’s stock would you buy if forced to choose one?

Welcome to new HIStalk Platinum Sponsor Redox. The Madison, WI-based company was founded in 2014 with the belief that EHR vendors can’t solve healthcare interoperability. The company’s API allows innovators the ability to code once, connect to all. It uses cutting edge methods such as HTTPS, JSON, and OAuth to create a modern Web experience without digging into HL7, FHIR, CCD, or DICOM. The company’s integration experts know how to get data into and out of EHRs using scalable integration strategies, enabling both software vendors and providers to integrate their apps, exchange information with affiliates, and commercialize innovation. Redox has already connected hundreds of enterprise applications. It monitors and maintains interfaces 24/7; expedites pilot testing; streamlines referral management, population health, and analytics; and creates a build-once environment that fuels innovation and scalability. The company also integrates wearables and home medical devices with EHRs and data warehouses; connects payors to providers; and integrates remote patient monitoring and telehealth services with medical groups and EHRs. Thanks to Redox for supporting HIStalk.

We funded the DonorsChoose teacher grant request of Mr. S in California, who asked for a Chromebook for his second grade class. He reports that the students are using it for online math practice, graphing, virtual field trips, and geography look-ups using Google Maps.

I noted that Nuance’s status updates contain the same infuriating error that I see in endless emails in claiming that a stated time is “EST.” There’s no such thing until November 5, when our clocks are turned back from “EDT,” or if you can’t be bothered to understand what the rest of us get, then just write “ET” and we’ll figure it out for you. The same folks are often confused by time zones and have to confirm for scheduled calls, “What time is it where you are?” to which I’ll provide this invaluable advice: just type “time in Phoenix” or “time in London“ in a Google search box and it will tell you in engaging zero of your brain cells. Daylight Saving Time is illogical, but that doesn’t mean you can just ignore how it works.

This Week in Health IT History

One year ago:

• University of Mississippi Medical Center agrees to pay $2.75 million to settle HIPAA charges related to the theft of an unencrypted laptop and discovery of an unsecured PHI-containing database.
• Athenahealth announces that EVP/COO Ed Park will leave his position.
• CTG CEO Cliff Bleustein, MD resigns.
• Kate Granger MBChB, MBE, the NHS geriatrician who created the “Hello, my name is” campaign that urge clinicians to introduce themselves to patients before treating them, dies of cancer at 34.

Five years ago:

• IRobot announces its first healthcare robot.
• Shares of Quality Systems (NextGen) drop 33 percent after a poor quarterly report and the loss of long-term customer HMA.
• The Commonwealth Fund announces former National Coordinator David Blumenthal, MD as its next president.

Ten years ago:

• Several companies bid for struggling NPfIT contractor iSoft.
• Mediware shuts down its OR product line to focus on “closed-loop systems.”
• Misys exits the healthcare business by selling its lab, pharmacy, and radiology software business to Vista Equity Partners and its Misys CPR product to QuadraMed, with both acquiring companies agreeing to support the Misys Connect strategy.
• Picis announces its intention to acquire ED revenue cycle software vendor Lynx Medical Systems.

Weekly Anonymous Reader Question

Responses to last week’s question:

• My boss knows me at a professional level and we do some small talk. He lives across the country, so we do not have any off-work interaction.
• None. I try to have as little interaction as possible with her at work, let alone socially.
• Zippo. They have no interest to ask, and I have zero interest to share. Best that way.
• He knows of my family , no names. No social interaction besides Christmas party, and there is no family allowed in the building.
• Not at all, and that’s the way I like it. I learned some hard lessons about being too familiar with management, and now I draw a hard line between my personal and professional relationships.
• None.
• I have found that my bosses have never really known much about me and my family socially, and we have had minimal interactions outside of work, and never outside of work events. For me, this led to some burnout because they were unaware of everything I was juggling. Because of that, as a boss myself, I’ve made an effort to know my team members and their family’s because it helps everyone perform better. If I know that you’re stressed because you have a particular family issue going on, it let’s me step in to help out at work to relieve some of the work stressors. When people feel like you care about them for more than just doing the work you need done, morale is higher and performance improves. And bottom line, part of being a leader is hopping into the trenches with folks and working side by side with them, which you can’t do unless you know what’s going on outside of the four walls of your office.
• We have zero off-work interaction. Frankly, we barely have on-work interaction. He is chronically late to our scheduled 1:1 calls and sometimes doesn’t show up at all. Something “more important” always seems to be coming up. I know I’m one of the top ranked members of his team and I’m generally self-sufficient, but there’s no way he’s ever going to do any professional development work with me if he can’t even show up on calls. BTW, it’s not just me he does this with. Upper management should be appalled but no one seems to care.
• He doesn’t. None. We spend so much time together during the week that we need to NOT see each other on the weekends. Same is true for our entire executive team. It is healthier that way. We get along just fine. Seeing more of each other would not be healthy then work would not creep but barge it’s way into the weekend.
• Working with my boss for the past 18 months, he has never met any of my family members. As a remote worker, off-work social interaction with my peers and boss does not occur. My company does not value this interaction with its remote workers; however, it does value this interaction with on-site office staff. Perhaps my company cannot justify the cost associated with social interaction with the families of its remote workers.
• I’m a remote employee, so “not at all” and “none”.
• Learned the hard way during my time at McKesson, MPT, that letting work and family mix is not always the best idea. When times got tough, I would hear things like, “You better work harder and sell more or you won’t be able to provide for your children.” And then refer to them by name and even what activities that they might not be able to do because we wouldn’t be able to afford it.
• All previous bosses took time to know me and my family within the first month of starting the position. We have a small team of six, so it is not hard to remember kids’ names and estimated ages. My current boss is in her third year and still has no idea what my kids’ names are. She avoids off-work interactions like the plague. Happy hour? No. Team building exercises during off hours? Absolutely not. On going team member conversation in the break room? No eye contact. To say the least, it is tough to work at a level of 110 percent to make someone look good who doesn’t know your kids’ names. I have always believed interpersonal skills are imperative in leadership and my current boss reinforces it that belief.
• No off-work interaction. We share normal chit-chat in the office, names of spouses/kids, school activities, etc., but that’s it.
• We don’t do anything socially or have any off-work interaction, nor is this encouraged or discouraged by the organization. I started my career with a consultancy who did an excellent job of pulling family into social activities throughout the year. In the 30 years since then, not really something my employers (hospitals, health plans) cared about.
• We had lunch the day I started. Otherwise, boss refuses to engage socially. No interaction.
• We don’t discuss family. Dogs, occasionally. There is minimal interaction outside of work and only incidental to work. Considering the question in terms of bosses I’ve had in the past, there have been some that really did care about everybody and everyone’s family. Would see them routinely out of work and even at their homes on holidays. Made work-life at the time enjoyable, sometimes a little too personal, and I can’t say the team was any more effective then ones I have participated on where this is not the case.
• Zero interaction with family or personal life. I live on the east coast, she lives on the west. I’m a telecommuter.
• Somewhat, but I would say 80% business.
• Well enough to think he knows a lot, which makes him happy, but he really doesn’t and it’s going to stay that way. He uses what he knows in weird and uncomfortable ways so additional sharing is off the table. It creates some awkward situations if he’s prying for more, but handling that is a better trade off than the alternative.
• My boss knows very little about me outside of work and that is the way I want it to be. Work life is work life and personal life is personal – separate from each other. Consequently, I spend zero time outside of work with my boss.
• No social interaction at all, and that is fine with me ~ like the boundaries!

This week’s question: What drives you crazy about the person at work who annoys you the most?

Last Week’s Most Interesting News

• Athenahealth’s quarterly results beat expectations even as the company is dogged by an activitist investor and its CFO leaves the company for another healthcare IT company.
• Google Glass is revived as X Glass Enterprise Edition, with healthcare one of the targeted industries.
• Epic’s first full-suite implementation in Canada goes live.
• The DoD’s second MHS Genesis pilot site goes live on Cerner.
• Emids acquires Encore Health Resources.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

From the Athenahealth earnings call, following results that sent shares up 8 percent on Friday:

• The company says enterprise software competitors can’t duplicate its recently launched work reduction guarantee for independent medical groups that differentiates its cloud-based services model.
• CMS has approved the company to received adjudicated Medicare claims data as a Qualified Entity, which it says will allow it to build up a scalable hospital service that can pre-populate information without requiring redundant data entry. Jonathan Bush says, “Athena will be the only company with an EMR that actually has medical records in it before you type them in.” He also describes the claims information containing 98 million patient records as a “data asset.”
• The replacement CFO search will focus on a “demonstrated record of operating discipline and value-creating capital allocation” who can analyze the potential return on investment of every company project as more of a COO and portfolio manager instead of just handling financial controls and accounting management.
• The company says it is winning 80 percent of the deals it goes after, the highest in its history.
• Bush says the company has a very high win rate in community hospitals, #1 in net hospital wins according to KLAS, mostly because they need systems quickly without using capital budget to improve cash flow. Still, he admits that the hospital business isn’t yet profitable and it represents the company’s shallowest product offering.
• Bush says the company’s recent $63 million acquisition of Praxify gives it modern technology that can containerize future app development as the aging AthenaNet platform is re-architected in “an intense crisis level of reconstruction.”
• Bush says electronic data interchange makes implementations tougher, especially in hospitals. “Hospitals will show up at the door with lab systems written before my children were born. Someday we’ll get the courage to say, here’s the app store. Buy any of these lab systems. We’ll pay, but we’re not connecting to that MUMPS-based museum piece.”
• Bush says the CMS-certified Qualified Entity application required completing a 700-page application and was completed only because the Trump administration changed the data sampling requirements. He adds that CMS is not technically ready to meet the requirements: “The government is on some very tired systems. So are the contractors. We understand that the way we will receive this data is they will send us a drive in a padded envelop by certified mail. We have people on eBay now looking for machines that can receive this drive.”
• Bush says of population health management, “Population health is population surveillance outreach, population engagement, and population love. Every health system needs to find out what population thinks of them as a prospective provider of choice and love on them in a digital continuous way rather than waiting for them to be the path to the hospital parking garage. As we get our population health clients to agree to that approach, we get a much bigger bite of their patient population and get much more traction.”

Decisions

• Boca Raton Regional Hospital (FL) will go live on Cerner in August 2017.
• Monroe Community Hospital (NY) will go live on Healthmedx Vision in August 2017.
• Gerald Champion Regional Medical Center (NM) will go live on Cerner CommunityWorks in August 2017.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.

Other

Part 3 of Vince’s HIS-tory of Cerner from a few years back covers how the company’s name was chosen (and by whom), stock performance, and how its lab system became #1 by the late 1980s.

Sponsor Updates

• Over 500 Mazars employees volunteer at community organizations in six states for its third annual “Days of Service.”
• ZappRx releases a new podcast, “It’s Hard to Prescribe Specialty Drugs.”
• Audacious Inquiry founder and managing partner Chris Brandt is named an Aspen Institute health innovator fellow.

Blog Posts

• How Aurora Health Care Improves Patient Care Amidst Changing Paradigms with Salesforce Marketing Cloud (Salesforce)
• Healthcare Payers and Providers Collaborate to Improve Outcomes (The SSI Group)
• 3 Simple Steps to Set Up Google for Your Practice (Solutionreach)
• What is Summit Healthcare Doing to Support FHIR? (Summit Healthcare)
• The Road to Perfecting E-Prescriptions (Surescripts)
• Can healthcare fraud special investigators keep up the pace? (Verscend Technologies)
• Can you? Visage can: Multiple Workflows (Visage Imaging)
• Quick connections lead to high-quality care. (Voalte)
• Visual Voice: Bridging the Customer Service Gap Between IVR and Agent (West Corp.)
• Building the Story (Zynx Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

News 7/21/17

Top News

Athenahealth reports Q2 results: revenue up 15 percent, adjusted EPS $0.51 vs. $0.34, beating expectations for both.

ATHN shares rose 7 percent in after-hours trading following the announcement. They’re up 15 percent in the past one year and 54 percent in the past five, but both significantly trail the performance of the Nasdaq index.

The company’s market value is $5.7 billion. Co-founder, CEO, and board chair Jonathan Bush holds shares worth about $45 million.

Activist investor Elliot Management disclosed in May 2017 that it had acquired 9.2 percent of the company’s outstanding shares and will try to force the company to consider “strategic opportunities.”

Reader Comments

From e(x)HMP: “Re: David Waltman’s golden parachute at Cerner. Not the first time he has found a way to fail upwards. He represents everything that is wrong with the VA/VistA fiasco. By all means, let’s give this guy a third shot.” The reader linked to a 2013 story about the VA’s $162.5 million contract award to ASM Research to improve the user experience with VistA, triple the price offered by two competitive bidders. One month later, the VA’s David Waltman – who had worked on the contract as chief UX architect of the iEHR project – announced that he would be leaving to take a chief strategy officer job with Accenture-owned ASM. ASM’s subcontractor in the project was Agilex, which had hired former VA CIO Roger Baker. Waltman lasted only nine months at ASM before going back to the VA as chief information strategy officer. Baker worked two years for Agilex, which was then also acquired by Accenture.

From Soft Machine: “Re: Teladoc and Analyte Health. Definitely headed toward covalent bonding. What do you make of them?” Analyte Health offers telehealth providers lab ordering, specimen collection, and testing services. The CEO is industry long-timer Kevin Weinstein, who was chief growth officer at Valence Health through its acquisition by Evolent Health. Teladoc and Analyte health announced a partnership in January 2017. Being a hospital guy, I’m not crazy about Teladoc’s model since I can’t fathom why hospitals don’t launch their own branded telehealth service with their own doctors and keep patients within their system (no different than retail clinics), but TDOC shares have doubled in price in the past year to a $2 billion market cap, giving the company money to use for acquisitions. Analyte Health would be a significant differentiator since many telehealth encounters involve an awkward lab test handoff and having integrated lab services opens the door to offering services for conditions beyond the usual rashes and ear infections. Hospitals that compete with or are indifferent to Teladoc might like working with Analyte Health since it doesn’t run its own labs – it contracts with hospitals and commercial lab providers and thus could steer business to the hospital lab.

From Aging Programmer: “Re: your HIT index. Loved it! I scored myself and got an 82. The main potential issue I see is the definition of management – maybe it should be managing at least five employees, in which case my score drops to 67. Ironically, my consulting time had almost as much impact as my CMIO experience, but I know there’s a lot of dead wood consultants out there.” I reviewed AP’s LinkedIn and I think his very high score of 82 seems about right given his medical education and extensive provider experience that emphasized informatics. I thought about trying to define the scope of management, but the only person who would know that is the individual since LinkedIn only lists titles, so I think you get points for title regardless of actual responsibility. In comparison, quite a few of the “most influential” folks would score in the low single digits with no healthcare-related education or significant health/health IT work experience. I’m certain many of them would protest that their speaking engagements, unpaid advisory board participation, and blog posts should boost their scores, but I don’t see how those necessarily qualify someone to render analysis and opinion. Nobody pays much attention to what armchair quarterbacks and barstool coaches think about football.

From Scribe Feedback: “Re: scribes. I’ve had two experiences with scribes in the past two weeks. The PCP scribe was new and could not navigate Epic well. The PCP was also coaching someone, so I was outnumbered four to one by the PCP, scribe, MD-to-be, and the nurse. The PCP spent 80 percent of his time focusing on the scribe and the person he was coaching while communicating with the nurse. The second interaction with the specialist was very good – he kept his eyes on me and after explaining the role of the scribe, it was like she wasn’t even in the room. The specialist also uses Epic. I’m not sure if the PCP’s documentation requirements caused the difference, but there has got to be a way to make the scribe less intrusive.”

From Can Spam: “Re: Athenahealth turnover. The amount of churn is remarkable. Since 2015, they’ve lost their chief technology and product officer, COO, two CFOs, and the VP who was instrumental in building AthenaNet. Likely more to come given the involvement of activist investor Elliott Management.” Investors have reacted positively to Elliott’s involvement (as they often do), although customers should probably be less enthused since it’s not necessarily in their best interest to have the company sold or broken up into more lucrative pieces.

HIStalk Announcements and Requests

We’ll be missing Dr. Jayne’s regularly scheduled post tonight as she struggles (yet again) with the Microsoft Surface she unwisely purchased that seems to have given her constant problems since. This time a software update killed it.

This week on HIStalk Practice: Waud Capital Partners acquires ChiroTouch. Nebraska HHS, HIE work with DrFirst to advance PDMP. Cow Creek Health & Wellness Center rips and replaces with help from Greenway. Solo family physicians advocate for low-cost, easy-to-use patient-generated data tools. New CDC director takesTwitter for a spin. Carolina Center for Occupational Health goes with Bizmatics HIT. Tom Lee, MD hands over One Medical reigns. North Carolina health officials find themselves in hot water due to a trail of data entry oversights.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Netsmart acquires home care and hospice software vendor DeVero.

The State of New York provides $2 million in tax breaks to electronic referrals vendor EHealth Technologies, which will expand its 215-employee Henrietta operations in adding 160 full-time positions in the Finger Lakes area. 

EHR security tools vendor Protenus raises $3 million in an extension of its Series A funding round that has raised $7 million.

Private equity firm Waud Capital Partners acquires chiropractic software vendor ChiroTouch from private equity firm K1 Capital, installing its own CEO as part of the “partnership.”

In the United Arab Emirates, Emirates Hospital — owned by UAE-based investment group KBBO – buys a 60 percent position in Dubai-headquartered MD 24-7, which offers online and face-to-face wellness and concierge services.

Sales

Medical Associates of Clinton, IA chooses EClinicalWorks 10e cloud-based EHR for its 49 providers.

People

PokitDok hires Joe Murad (Willis Towers Watson) as CEO and board member. He replaces co-founder Lisa Maki, who remains on the company’s board.

AHIMA announces in a member email that CEO Lynne Thomas Gordon’s last day was July 15, although it did not provide a reason for her departure. A search for her replacement is underway.

Home care software vendor HHAeXchange promotes Greg Strobel to president and CEO. Founder and former CEO Raphael Nadel will become chief innovation and strategy officer.

Missy Krasner (Box) reportedly joins Amazon in unannounced healthcare role.

Announcements and Implementations

Arizona Pulmonary Specialists (AZ) and Harbor-UCLA Medical Center (CA) go live on ZappRx’s specialty medication drug prescribing platform, with the director of Harbor-UCLA’s pulmonary hypertension center saying its first prescription was approved within 48 hours vs. the common paper-based process that sometimes took more than three weeks.

Three of North Carolina’s largest health systems – Novant Health, Carolinas HealthCare System, and Duke Health – will connect to the state-operated HIE NC HealthConnex, which also announced that the Coastal Connect regional HIE will join.

Seventy-bed Jones Memorial Hospital (NY) and two other hospitals affiliated with UR Medicine receive a $5.7 million state healthcare transformation grant to replace Meditech and LSS with UR’s Epic system.

In Ireland, a former hospital CEO develops CliniShift, a staffing app that allows a hospital to match its vacant shifts with available staff. It also tracks the status of credentials and allows managers to monitor how the app is being used. The company expects to begin a pilot project at an unnamed large hospital on the US East Coast in September and has opened an office in Boston. 

Meditech announces that it will offer CommonWell interoperability services in early 2018.

Change Healthcare joins the Hashed Health blockchain technology consortium.

Government and Politics

England’s NHS Digital responds to a review of its practices that notes ambiguous expectations, a lack of centralization of innovative ideas, worse than expected feedback fro its data services customers, and reliance on outdated technologies. NHS Digital says it will:

• Implement an effective enterprise architecture function
• Create a service operations capability and future roadmap
• Standardize delivery methodologies
• Create a build vs. buy strategy
• Develop a unified security model and security operations center
• Implement new business intelligence and customer relationship management tools
• Work more closely with stakeholders
• Create a thought leadership program
• Create an investment approval subcommittee of the NHS Digital Board
• Set up a workforce planning center to extend recruitment and review the eight office locations

An investigative article finds that HHS is using taxpayer money that was intended to promote Affordable Care Act insurance signups to instead fund a PR campaign against it, creating videos of people who claim to have been harmed by the ACA. The White House chose the video subjects and flew them to Washington DC, with some of those participants later saying that the HHS people pushed them into being more negative about the ACA than they really feel. Former CMS Acting Administrator Andy Slavitt commented, “Congress appropriates funds for you to carry out laws they passed, not to spend those funds on activities that counteract those laws.”

Privacy and Security

Japan will take “strict action” against drug maker Bayer, which acknowledges that three of its employees inappropriately accessed survey-generated patient data to plan a promotion for the company’s Xarelto blood thinner.

Fortified Health Security releases its mid-year cybersecurity report.

Other

Sherpaa founder Jay Parkinson, MD, MPH blasts the venture capitalists who funded his company, then tried to liquidate it given the inherent disconnect between the VC desire to quickly scale and sell out vs. the “glacially-moving industry” of healthcare. Sherpaa’s handful of employed doctors offer online-only routine primary care encounters, charging individual customers $270 per year for unlimited app visits 24×7, which includes managing prescriptions, lab tests, referrals, and second opinions. Parkinson said the investor made himself CEO and then fired all the staff, including the doctors who could not legally stop seeing patients without giving them advance notice. He also accuses the investor of sending the company’s primary competitor, One Medical, its client and payments list in unsuccessfully trying to sell the company. The investor/CEO and board finally resigned a year ago and left the company’s remains for Parkinson to revive, but Parkinson says One Medical’s sales team then used Sherpaa’s proprietary information to badmouth it and to undercut Sherpaa’s employer rates. It’s an interesting idea and certainly cost-effective given the expense and overhead of arranging a PCP visit, but I would have to wonder how the VC was pitched in the first place. The company requires no upfront fee or ongoing commitment, so anyone who wants to give it a shot only has to pay the the first month’s $25 and then request a visit. I’m not sure how their doctors handle prescribing across state lines or how they manage referrals that are within the customer’s insurance network. 

An insightful editorial says it’s counterproductive to call someone who is experiencing g a horrible disease – specifically Sen. John McCain – a “fighter” since the “warrior rhetoric” doesn’t improve their outcomes and can cause them to feel that they’re letting people down if they struggle or if they wisely choose palliative care instead of suffering through more rounds of painful treatments that offer little chance of success.

A Cancun, Mexico hospitals refuses to allow a premature baby to be transported back home to the US until the parents pay $30,000. That solved Mexico problem preceded the inevitable US one – the grandparents paid $18,000 for air transport to a Florida hospital that refused to accept the baby because of the mother’s Indiana Medicaid insurance, so now they’ll have to pay another $30,000 to get him to Indiana.

Sponsor Updates

• Liaison Technologies awards its first data-inspired Future Scholarship to high school graduate Antonio Ferris of Mesa, AZ.
• Tech.MN includes LogicStream Health in “The Ultimate Guide To HealthTech in Minnesota.”
• Santa Rosa Consulting is named a “best place to work”by Modern Healthcare for the sixth consecutive year .
• Optimum Healthcare IT is named one of the 50 fastest-growing companies in Northeast Florida for the second straight year.
• LogicWorks partners with CloudHealth Technologies to optimize cloud management and performance.
• Meditech will exhibit at the AHA 2017 Leadership Summit July 27-29 in San Diego.
• Obix Perinatal Data System, developed by Clinical Computer Systems, will exhibit at the AWHONN Florida Section Conference July 27-28 in Ponte Vedra, FL.
• Experian Health receives the 2017 MongoDB Innovation Award in the healthcare category.
• PatientSafe Solutions joins the Integrating the HealthCare Enterprise as a member organization.

Blog Posts

• The Hidden Costs of Dirty Orders (Liaison Technologies)
• Centralized Appointment Scheduling Aids Patient Experience (MedData)
• How to utilize CPT 99490 to increase revenue opportunities (Meditech)
• In a Troubled Healthcare System, ‘Digital Empathy’ is the Way Forward (HealthLoop)
• The CY2018 Medicare Physician Fee Schedule Proposed Rule – The Upshot (National Decision Support Co.)
• A Day in the Life: You Know You’re a Practice Administrator When … (Navicure)
• Clinical Alerting: The Key to a More Intelligently Connected Hospital (Spok)
• Passion and Vision for the Future: The Legacy of Neal Patterson (Netsmart)
• The Friction at the Gala: Getting to know the “Solver in Chief” (NTT Data Services)
• Helping Hands, CloudWave and Community Hospitals (CloudWave)
• Why Chronic Conditions Need Continuous Care Coordination (PatientPing)
• The Real Health IT Prize (PatientKeeper)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

News 7/19/17

Top News

Google revives its long-dormant Glass hands-free display – which never graduated from consumer beta status — with an enterprise edition that can run apps, display training materials, and connect workers with colleagues via a live video stream.

Technically Glass Enterprise Edition is part of X, the “moonshot company” research subsidiary of Google’s parent company Alphabet. The still-mothballed Glass Explorer Edition is under Google’s hardware group.

Google is featuring Glass’s use as an EHR remote scribe charting and documentation solution as sold by Augmedix.

SwyMed will deploy its telemedicine solution on Glass Enterprise Edition as part of its DOT Telemedicine Backpack, which connects mobile care providers to doctors in real time. 

Reader Comments

From Bill: “Re: Nuance. Seriously mis-timed marketing or a company that just doesn’t care after two weeks without service to some health systems.” Some Nuance systems remain offline 21 days after its malware attack, so perhaps the new client pitch could have been timed better. Still, the company has to continue on under the assumption that its systems will eventually be fully restored.

From Unbreak Healthcare: “Re: Athenahealth. A university practice customer wanted to directly send outbound orders to the hospital lab’s LIS and EHR after finding that poorly configured fax orders were sending one order per page, meaning thousands of pages per day. However, Athena only allows transmission of outbound orders by its AthenaCoordinator Receive Lab Orders. The company wants to charge the hospital (which has no desire to be an Athena ‘customer’) subscription model pricing instead of as a one-time fee, incurring a significant cost for each patient requisition with some discounts for volume. This has not been warmly received by the hospital. Thanks, Jonathan, give me more of this disruption, please!” Unverified, but the document above that I found on Athenahealth’s website says labs can receive orders only if they sign a contract and pay $1.00 per order. 

From Expanding Paunch: “Re: HIT100. I’d like to see the winners scored on real-life experience and accomplishments instead of chronic Twitterhea.” I spent way too much time thinking about this idea, coming up with a scoring methodology that reflects what I look for in assessing someone’s accomplishments in deciding whether they are therefore qualified to render healthcare-related opinions. Here’s my first pass – score yourself and your peers and tell me which criteria you would change. I’ll grade the HIT100 once they are named, using the self-reported information (often inflated) from their LinkedIn profiles since everything should be right there. The scores I tested tracked pretty closely to my assessments of some of our industry’s more prolific pundits, ranging from 0.5 points to over 70. I was kind in deleting an additional metric that deducted points for using self-styled, questionably accurate labels such as thought leader, visionary, thinker, innovator, and entrepreneur.

HIStalk Announcements and Requests

The latest in my long string of pet peeves is using the initialism CMO, which in our industry means chief medical officer, not chief marketing officer. I’m also annoyed at sites that use trademark and copyright symbols when referring to products and companies – that’s not good form outside of company-produced material since those symbols apply to commerce, not journalism. I’m also frustrated at awkwardly worded sentences caused by incorrectly using “there” as a subject and then stubbornly trying to wrangle the rest of the sentence into submission, but that’s hardly new.

Listening: new from Charlotte & Thieves, a Norway-based band whose moody, slow song “Apparently” is quite fine.

Thanks to new HIStalk and HIStalk Practice Founding Sponsor Medicomp Systems. I have just two Founding Sponsorships available on each site (both of which have been held by the same companies for 10+ years, Medicity being one) and Nuance’s new marketing person hadn’t heard of HIStalk and decided to end their sponsorship, after which at least a dozen companies expressed interest in grabbing their Founding spot. Medicomp got first dibs as the oldest sponsor, with CEO Dave Lareau (he did a great interview with me a couple of years back) graciously stepping up as he has in years past, including sponsoring great HIStalkapaloozas in New Orleans and Orlando. Physicians and nurses love Medicomp’s intuitive Quippe documentation and clinical viewer tools that work with any EHR and allow them to see more patients with better usability and more focus on the patient instead of the screen while giving them the full clinical picture. Quippe Clinical Lens offers a problem-oriented view of all relevant clinical data for any disease state, eliminating the clinical static to improve effectiveness and efficiency. Medicomp has been singularly focused since 1978, when it was founded by legendary MEDCIN terminology inventor and company president Peter Goltra (I met him years ago at a HIMSS conference and he’s an impressive and humble guy). Thanks to Dave and Medicomp for supporting HIStalk and HIStalk Practice, not just now, but for many years running.

Here’s a overview video I found on YouTube describing how Medicomp’s Quippe Clinical Lens helps prevent MACRA-caused lost productivity and physician dissatisfaction.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Ability Network acquires patient payments management system vendor Secure Bill Pay.

Bright.md, which offers a patient interview tool for telehealth visits, raises $8 million in a Series B funding round, increasing its total to $11.5 million.

Singapore-based ST Engineering will acquire TUG robot vendor Aethon for $36 million. Aethon — which had raised $56 million but reported an asset value of negative $1 million as part of the acquisition — sold its pharmacy logistics line last week.

The private equity owner of EMDs is looking for a buyer, according to a Wall Street Journal article that estimates the EHR vendor’s 2017 EBITDA as $13 million.

Sales

Colorado’s HHS chooses H4 Technology’s Compass data management and analytics platform for its behavioral health program. Founder and CEO Chris Henkenius also founded Stella Technology.

People

Cleveland Clinic (OH) hires Ed Marx (Advisory Board) as CIO. He replaces Martin Harris, MD, MBA, who left late last year to become AVP/chief business officer of the Dell Medical School at the University of Texas at Austin.

e

Karl Stubelis (Athenahealth) joins Arcadia Healthcare Solutions as CFO.

Joe Alberta (Verscend) joins OmniClaim as SVP of sales.

Announcements and Implementations

In Canada, Mackenzie Health goes live on Epic’s first full-suite implementation in a Canada-based hospital.

CMS qualifies National Decision Support Company’s CareSelect as a decision support platform for Appropriate Use Criteria under PAMA and MACRA.

The patent office issues a patent to Sphere3 for its Aperum LeadIt, which correlates data from nurse call lights, smart beds, and RTLS to patient care perception.

Government and Politics

Sen. Chuck Grassley (R-IA) writes a lot of indignant letters making demands that go nowhere, so here’s his latest – he and Sen. Orrin Hatch (R-UT) want CMS to go after the $729 million in Meaningful Use incentives that HHS OIG estimated was overpaid in its June 2017 report. The senators also want to know how much of the $291,000 was recovered from the 14 sample EPs who were found to have been paid too much and are asking for a random review of EP self-attestation documentation.

The DoD’s MHS Genesis project continues as its second site, Naval Hospital Oak Harbor (WA), goes live on Cerner. Meanwhile, Cerner hires former VA IT executive David Waltman for its federal team. He led the VA’s VistA Evolution program before a short stint as chief strategy officer of federal IT contractor AbleVets.

Missouri Governor Eric Greitens signs an executive order directing the state’s Department of Health and Senior Services to create a prescription drug monitoring program database. Missouri is the only state that doesn’t have a PDMP database, but experts say the state’s new one won’t be fully functional since pharmacies will be required to submit prescription information, but doctors and pharmacists won’t be able to us it during prescribing and dispensing — it’s only intended to be used by pharmacy benefits managers to monitor drug cost and overprescribing. The governor signed the order at the headquarters of pharmacy benefits manager Express Scripts. Lawmakers question whether the governor’s order is legal since his office can’t allocate spending, so the legislature will be required to provide any funding to create it.  

A Politico article observes that the Affordable Care Act gave hospitals – especially big ones – more paying customers who would previously have been charity cases, with the top seven hospitals enjoying a combined $4.5 billion annual revenue boost while their charity care dropped by 35 percent. The article notes that hospitals still enjoy tax-exempt status and adds, “Many US cities boast hospitals that are among the best in the world, but the communities around those hospitals might as well be the Third World” as the non-profits provide their executives with million-dollar salaries and country club memberships.

United Hospital Center (WV) will go live on parent company WVU Medicine’s Epic system on August 1.

Technology

Microsoft, always late to any technology party, will set up an artificial intelligence research lab.

Other

The interim CEO of NYC Health + Hospitals declares its implementation of Epic a success in two Queens hospitals, citing improved patient experience, growing patient interest in MyChart, a reduction in time from ambulatory visit arrival to completion from 104 minutes to 80 minutes, and improved management of unscheduled visits. He also says improved capture of patient information has increased the case mix index in adding $7 million in revenue in one hospital. The organization will begin rolling out Epic’s revenue cycle system in Q4 2018 and expects to complete the full Epic implementation by the end of 2020.

Eric Topol tweeted out an interesting study about whether people can detect Photoshopped news photos, which the article concludes they cannot. The article’s genesis was a 2015 photojournalism awards program in which 22 entries – including the winner – were disqualified for manipulating their entries. Everybody already knows this, but just because you see a photo or video doesn’t mean you’ve seen truth.

A remarkable LA Times story finds that USC’s former medical school dean hung out with criminals and prostitutes and was a a crystal meth and ecstasy user, all unwisely captured in photos and video. He quit his $1.1 million job after word leaked out that his 21-year-old female companion’s hotel room overdose on a date rape drug required him to call 911. USC also placed him on leave as an eye surgeon once the story ran.

In India, a hospital contract nurse who hadn’t been paid for two months beats up a doctor on rounds “with her footwear first.” Also in India, the local government orders several nursing schools to suspend classes for five days and send their students to hospitals as replacements for their striking nurses.

Sponsor Updates

• The Boston Business Journal recognizes Definitive Healthcare as the fourth-best place to work in Massachusetts.
• Besler Consulting releases a new podcast, “A new study shows readmission penalties don’t correlate to heart attack outcomes.”
• The Tampa Bay Business Journal recognizes AssessURHealth’s Kyle Mynatt as a Hero at Work.
• CareSync publishes a new white paper, “Chronic Care Management: Improve Patient Health, Increase Practice Revenue.”
• Cumberland Consulting Group is included in Gartner’s “Market Guide for Revenue Management in Pharma and Biotech.”
• Direct Consulting Associates will exhibit at mHealth & Telehealth World July 24-25 in Boston.
• Elsevier and HIMSS Asia Pacific launch the CMO of the Year Award.
• Healthgrades will integrate Medicom Health’s health risk assessment tool with its CRM solution.
• EClinicalWorks will exhibit at the 2017 Michigan Primary Care Annual Conference July 24 in Acme, MI.
• FormFast announces that over 100 “Most Wired” healthcare organizations use its technology.
• InterSystems will exhibit at the Defense Health Information Technology Conference July 25-27 in Orlando.
• Medical Billing Service Review includes AdvancedMD in its list of top five medical billing service companies.

Blog Posts

• Meditech’s Mobile Blood Bank Improves Speed, Safety of Donation Drives in Botswana (Meditech)
• 12 Pitfalls of Electronic Patient Signatures in Registration (Access)
• The real problem with EHR training isn’t webinars, learning styles, or physician buy-in (Nordic)
• The bad news about CMS’s planned delay to the EHR upgrade mandate (Advisory Board)
• Infusion Insight: The AAMI Foundation’s National Coalition to Promote the Safe Use of Complex Healthcare Technology (Ivenix)
• Developing a Sense of Urgency in Healthcare (Optimum Healthcare IT)
• #AHRA2017: Impressions from the exhibition floor (Agfa Healthcare)
• SaaS, PaaS, IaaS: What’s the Difference? (Datica)
• Are you a brilliant woman? We’d like to talk. (Nordic)
• Tapas on FHIR (Infor)
• Provider Sentiment Around Prior Authorization (CoverMyMeds)
• Keep Teams on Track with Project Management (CTG)
• Advantages & Disadvantages of Working Remotely (Direct Consulting Associates)
• The Nuts & Bolts of Potential Health Insurance Changes (Dynamic Computing Services)
• How to Succeed in Value-based Care (Diameter Health)
• Visual Standards in Dashboard Design (Dimensional Insight)
• Revisiting Productivity as a Basis for Compensating Physicians (ECG Management Consultants)
• The house call, once upon a time (EClinicalWorks)
• The Evolving Role of Digital Marketing in Healthcare (Evariant)
• How to Reduce Billing Errors Using GE Centricity EMR Forms (Hayes Management Consultants)
• EHR Implementation: You’ve Signed a New EHR Contract, Now What? (The HCI Group)
• 6 Ways Content as a Service Boosts Your Business (Healthwise)
• CIO Chat – Mike Maksymow, Beebe Healthcare (Huntzinger Management Group)
• Why Professional Dress Isn’t Really About Clothes (Impact Advisors)
• Roaming quickly and securely at Cumberland Healthcare (Imprivata)
• 6 Best Practices for Healthcare Brand Governance (Influence Health)
• Six ways actionable insights can impact top and bottom lines (Ingenious Med)
• How a Mobile-First World Influences Your Patients (Insta Med)
• Building a business case and governance for your EMR (InterSystems)
• Three Patient Access Models: How Health Systems Can Find the Right Fit (Kyruus)
• Medical Device Data Transparency Could Help Health Systems Hit the Elusive Supply Chain “Supply Spot” (First Databank)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

Curbside Consult with Dr. Jayne 7/17/17

There’s a well-known quote attributed to Henry Ford: “Quality means doing it right when no one is looking.” Sometimes that’s a hard sell for organizations that haven’t done the cultural transformation work to make it a reality. Practice administrators sometimes make excuses for this with the old adage, “When the cat’s, away the mice will play” or try to convince me that their team just tends to slack off.

Usually this conversation segues right into the concept that what gets measured gets managed, and that there are ways to motivate people that don’t always involve having a manager looking over their shoulders. Quality is often driven by the goals we set for people – whether they are goals related to compliance with a specific processes or to a desired outcome.

I’m a big fan of setting both individual and organizational goals. I’ve worked with too many organizations that either set one or the other, or try to blend goals but give too much weight to one. When individuals are overly incentivized without the right systems in place, we sometimes see a breakdown in teamwork.

I’ve seen members of consulting teams who jeopardize their clients’ success by scheduling them far into the future when other team members have current capacity — to make sure they hit their billable metrics. Others may create their own collateral and tools and not share with peers because they feel it offers them a competitive edge. They don’t believe that the rising tide floats all boats, but rather seem to be focused on making sure their boat doesn’t take on any water and stays farther ahead than the competition.

When organizations swing too far to the group incentive side, I tend to see formerly hard-charging individuals begin to withdraw. They may feel that the group is pulling them down or that they aren’t empowered to lead the group to higher levels of achievement. If the group incentives aren’t aligned with what individuals can actually impact, we sometimes see outright apathy.

I saw this recently with a group of workers who previously had individual productivity goals that were directly tied to tangible bonuses and were then shifted to a bonus framework that was tied exclusively to the overall financial performance of the hospital. They had done a great job controlling their own costs and utilization metrics under the previous system, but were disheartened at knowing that poorly performing departments would likely cost them their bonuses in the coming year. Since there weren’t any cross-functional initiatives to take the successes from one team and implement them elsewhere and there weren’t any ways for the teams to work together, they saw it as a lose-lose situation and their own performance suffered.

These are always challenging issues to deal with in healthcare, where our ultimate customer is a patient with a health need. It sometimes feels crass to talk about processes and metrics when you’re working with a certain quantity of human suffering in the equation. Of course, there are extremes: organizations that seem to treat the patient like a widget that can be moved from point A to point B and always with the same characteristics. Such organizations are often accused of being heartless or profit-driven, regardless of their not-for-profit status. The other end of the spectrum often fails to understand the business ramifications of their processes and decision-making or refuses to factor in efficiencies due to the perceived uniqueness of each patient’s or worker’s situation.

As with many things, the answer is typically somewhere in the middle and this also applies to how we incentivize our teams. In addition to balancing individual goals, we also need to look at blending both short-term and long-term goals. When the finish line (or the prize) is too far in the future, it’s hard to stay motivated.

This is the particular challenge we are seeing in trying to motivate physicians and their teams to fully engage with quality initiatives. I think many of our friends in government assume that physicians are motivated by money, hence the way regulatory programs have been structured. Although a good number of physicians took advantage of the incentives or finally jumped in to avoid the penalties, others were more motivated by the idea of autonomy and continue to opt out. One could argue that the incentives (or penalties) weren’t large enough to meaningfully hit people in the pocketbook, but that only applies to some.

Autonomy can sometimes be a negative force when we’re looking at clinical transformation, as providers feel that “their way” is better than that of their peers and don’t want to come together to participate in common care paths or clinical protocols. I’ve seen this to the point of irrationality, where one physician was willing to leave the practice because her personal colorectal cancer screening protocol (which incidentally didn’t mesh with current available data) was not built into the EHR’s clinical decision support framework. Providers like this are the same ones who argue with me when I recommend posting signs for diabetic patients to remove their shoes (shown to increase the percentage of diabetic foot exams) because they have any number of reasons they disagree with it.

In order to be successful under new value-based care systems, we have to let go of some of that autonomy and figure out how to align our individual goals with those of both small (practice) and large (ACO) organizations. We also have to design systems to address short term “wins” such as a more efficient workday that will help get people to the right psychological space to play the longer game with quarterly holdbacks and annual payer incentives.

Finding the right way to motivate people is always a challenge. Physicians tend to be at least a little competitive, having been through the process of medical school admissions, residency matching, and finally entering their fields. Some will be motivated by seeing their performance against their immediate peers, such as partners or hospital data, more than they will be motivated by national benchmarks. Those individuals love real-time reporting or as close to real-time as their technology will allow. They may be more willing to participate in operational tweaks to streamline outcomes and have a vested interest in being part of the solution. Others who are less competitive or unsure of their own abilities tend to shy away from those frameworks, needing more individual coaching or peer-to-peer involvement to be successful.

This spectrum varies across specialties as well. Some have been used to publicizing complication rates for some time, where others find this brand new. One has to be careful with competition though, especially when you’re dealing with top-caliber people and processes. I am working with one organization where all of their providers are routinely in the top decile for various care metrics, if not in the top 3-5 percent. Pitting them against each other isn’t going to be productive from an efficiency (or psychological) perspective.

There’s no magic recipe or secret sauce on how to incentivize people. The best advice I can offer an organization is for them to spend time and energy consciously thinking through these concepts and working with their managers and employees to find a solution that will motivate them to excellence. Assuming it’s one size fits all is a mistake but one that I see all too frequently, as is assuming that people are just intrinsically motivated to do the right thing.

How does your organization motivate people? Email me.

Email Dr. Jayne.

Emids Acquires Encore Health Resources

Global health IT services provider Emids has acquired Encore, A Quintiles Company, the company announced this morning. Terms were not disclosed.

Pharma development services vendor Quintiles acquired 300-employee Encore Health Resources in 2014 for an unspecified price. Quintiles merged with competitor IMS Health to form QuintilesIMS in a $9 billion deal in May 2016.

Encore will be operated as an Emids business unit under Tom Niehaus, president and CEO of Encore. Encore co-founder Dana Sellers will join the Emids board. Encore has 200 consultants.

Sellers and Ivo Nelson launched Encore Health Resources in early 2009 with headquarters in Houston, focusing on EHR-related services. The company gradually transitioned into analytics.

Nashville-based Emids also has offices in London and Bangalore.

Emids Founder and CEO Saurabh Sinha said in a statement, “As healthcare becomes more integrated and the focus on consumerism grows, payers and providers are working more closely together. The ability to provide healthcare technology expertise and solutions that serve both payers and providers, as well as healthcare technology partners, will be critical to help our customers succeed in the future.”

Monday Morning Update 7/17/17

Top News

Athenahealth CFO Karl Stubelis resigns “to pursue other opportunities” after just over a year on the job. Board member Jack Kane has been appointed to serve as interim.

Stubelis’s predecessor Kristi Matus resigned in May 2016 “to pursue other challenges” that her LinkedIn profile suggests she hasn’t found yet.

ATHN shares closed up 2 percent Friday on the news, but the year-long price chart is basically flat.

Reader Comments

From IT Guy: “Re: expensive implementations like at Mayo Clinic. Same thing is going on at NYCHHC. With the total cost of some of these implementations, these hospital systems could literally BUY an HIT vendor.” We had that discussion many years ago at my hospital, where I somewhat jokingly suggested that we buy the company instead of its product since the investment wasn’t much different and we could at least control our own destiny. We also signed up with a desperate vendor that we privately worried we would drive out of business via the overly generous contract they signed in trying to meet that quarter’s revenue target. Don’t forget, however, that the software vendor’s licensing fees are a tiny chunk of the contract’s value, with most of the cost being labor (both internal and external), third-party licenses, and hardware. A $1 billion Epic implementation does not mean the health system writes Epic a $1 billion check. It’s also true that the client would have borne some of those expenses anyway – it’s not like they went from paper to Epic, they were already paying contract fees and labor for the legacy systems being replaced and the savings will offset some part of the new system’s cost. Finally, a lot of the figures you see are just a rumored number with no confirming detail.

HIStalk Announcements and Requests

More than half of poll respondents spend one hour or less each week on Facebook, with many of those not using it at all. Thirty-eight percent are on the site for one to 10 hours, while around five percent of respondents spend more than 10 hours weekly on Facebook. I can’t personally imagine that the seven people who park for 20 or more hours each week won’t eventually regret spending a big chunk of their lives staring at an imaginary world instead of taking 10 steps outside to see the real one where actual people and experiences live, but that’s just me. Quite a few people live under the illusion that they aren’t under Facebook’s spell, a premise easily disproven by observers who can plainly see how often and how long they are entranced by it on their PCs and phones.

New poll to your right or here: of the endless number of awards available in healthcare — most of them created solely to advance the agenda of the awarder – which ones do you think are meaningful? (you can choose more than one). Click the Comments link on the poll after voting to explain.

I was reading yet another celebratory announcement about a donor who funded the purchase of some hospital’s new diagnostic imaging machine as a benefit to the community. I’m puzzled why it’s a community benefit since the hospital isn’t going to perform those procedures for free (begging the question, why not?) The hospital will undoubtedly profit from cranking out more billable procedures on the machine, paid for by the insurance companies of those same community residents and thus raising the costs for all. As I’ve said before, I’ve spent most of my career working for hospitals and never, ever would I donate money to one or mistake them for a charity rather than a business of questionable motivation and management.

I’ve just about run out of DonorsChoose money even though I have matching funds left, but the project we funded for Ms. A in South Carolina  was a big hit as her students “clapped and cheered” when their new “teacher’s table” arrived, giving them a space to work on small group projects.

This Week in Health IT History

One year ago:

• Hacker The Dark Overlord lists the digital assets of breached healthcare IT vendor PilotFish Technology on the Dark Web.
• The VA hires KLAS for $160,000 to advise in on an EHR selection.
• Philips acquires Wellcentive.

Five years ago:

• Dissident Quality Systems shareholder and board member Ahmed Hussein launches his fourth attempt to take control of the company by nominating his own board.
• The CDC reports that 55 percent of US doctors use some type of EHR, with an 85 percent satisfaction rate.
• SAIC announces that it will acquire MaxIT Healthcare for $473 million.
• Microsoft reports the first quarterly loss in its 26-year history as a publicly traded company, triggered by a $6.3 billion write-down of its purchase of ad platform AQuantive.

Ten years ago:

• Cerner announces the retirement of 48-year-old COO Paul Black.
• A Modern Healthcare editorial says “national interoperability can wait” and instead advocates the use of patient-carried smart cards that contain information downloaded from each provider’s EHR.
• McKesson announces plans to acquire Awarix.

Weekly Anonymous Reader Question

Responses to last week’s question:

• Evernote has become my go-to app for everything from minutes, notes, and online article indexing to creativity with its drawing capabilities. All data elements are available on all devices, which alleviates access issues, especially for those of us with a hectic travel schedule.
• I use the Hemingway Editor to trim emails and write-ups. Brevity is a virtue.
• OneNote. I use it to organize meeting notes and key documents that are needed for reference. I take handwritten notes during conference calls and then take photos of the notes to post in OneNote for recall later.
• CamScanner on my smart phone to create PDFs. Allows me to work on expenses during my travel — no scanner required.
• FollowUpThen.com, a free service that automatically reminds you about emails you send to other people after whatever time you specify elapses. For example, if I email my co-worker asking for some information or action, I can add 2days@followupthen.com in the BCC field, and I’ll get a reminder in two days about it. If I put the email address in the CC field instead, we’ll both get reminders. It’s like a nearly-automatic task list for email follow-up.
• Any time (iPhone or http://e.ggtimer.com/) where I can put 60-90 minutes on the clock, turn my phone over, minimize Outlook, and dig into something without interruptions. That and Evernote.
• Evernote. Love being able to synch notes between my ipad, PC, and phone. Use it for everything from meeting notes to grocery lists.
• OneNote. It’s an amazing tool for keeping me organized and I’m sure I don’t even use a fraction of its capabilities.
• Google Inbox.
• Outlook. As much as I have a love-hate relationship with it, it has a fair amount of flexibility to do the things your need if you spend the time to set it up fully.
• Excel. I can dump and sort data there. If I’m trying to reason something out, I can structure my thoughts in a list or table and easily add rows/columns.
• Tiny Scanner. Mobile scanning app, free, and it has saved my neck so many times.
• Datawatch’s Monarch software. I was a programmer/analyst before I retired but when I worked there wasn’t a day that went by where I didn’t use Monarch for data/problem analysis. You could create ad hoc extracts or put code in scripts using Monarch to extract data from downloaded reports and delimited or fixed length files. Coupled with some other free or inexpensive software that ran in DOS (and its successor environments) like febootimail, WinSCP, etc., I could put together a script that grabbed a standard report from an HIT system, separated the wheat from the chaff, put it into a human- or machine-readable format and email/FTP the output, typically in less than a couple of hours. I’ve been out of the HIT biz for a few years now and I still use a personal copy of it from time to time.
• SelfControl www.selfControlapp.com. Free open-source application for Mac OS. It lets you block your own access to distracting websites, your mail servers, or anything else on the Internet. Just set a period of time to for blocking, add sites to your block list, and start. Until the timer expires, you will be unable to access those sites–even if you restart your computer or delete the application. ColdTurkey https://getcoldturkey.com, Flexible and difficult to circumvent. Dashboard accommodates a weekly schedule, including a lock to prevent the impulse to make changes during the lock time. It accepts brea ktime between work periods. It will allow for setting up blocking everything except for a few sites, or the entire Internet, and offline games. Wonderful for assuring sleep time with Frozen Turkey, a feature which assures you’ll be locked out of your device for a specified period of time. It is also activated 10:30 p.m. to 6 a.m. on kids’ devices during the week.

This week’s question: How well does your boss know you and your family socially? What off-work interaction do you have?

Last Week’s Most Interesting News

• Mayo Clinic goes live on Epic at the first sites of its $1 billion implementation.
• Cerner Chairman, CEO, and co-founder Neal Patterson dies of cancer at 67.
• Jawbone’s financial pressures lead to its planned shutdown, with its founder moving on to data acquisition and analysis vendor Jawbone Health Hub.
• Some Nuance cloud-based systems remain unavailable to users nearly three weeks after its June 27 cyberattack.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Collectly — which offers EHR-integrated personalized debt collection programs with a focus on physician practices — raises $1.9 million in seed funding. The company charges a flat rate of 10 percent of collected debts that are less than six months overdue.

Sales

Baylor Scott & White Health (TX) chooses Kyruus for provider search and scheduling across its 48 hospitals and for its API-powered ability to match consumer-reported conditions and symptoms to potential providers on its website.

Decisions

• Mary Starke Harper Geriatric Psychiatry Center (AL) went live on CoCentrix in 2017.
• Cozad Community Hospital (NE) will replace NextGen Healthcare’s revenue cycle management software.
• Several Select Specialty Hospital locations will implement Epic.
• Treasure Valley Hospital (ID) will replace Healthland with Cerner in July 2017.
• Saint Thomas Highlands Hospital (TX) will implement Cerner in October 2017, replacing Medhost.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.

People

Howard Landa, MD (Alameda Health System) joins Sutter Health as VP of clinical informatics/EHR.

Stony Brook Medicine hires Kathy Ross, MBA (Ascension Health Services) as CIO.

Announcements and Implementations

A tiny Reaction survey of 113 ambulatory providers finds that a significant percentage of them trust EHR vendors less in general following news that EClinicalWorks paid $155 million to settle Department of Justice charges, with two-thirds of them also indicating that they probably won’t consider buying EClinicalWorks in the future.

Other

The local paper covers the replacement by Kittitas Valley Healthcare (WA) of its NextGen, Empower Systems, McKesson Paragon, and McKesson Horizon Home Care with Cerner.

Interesting: a failing, formerly county-run Alabama hospital prevails in a four-year-old legal battle over the 12 citizens of China it recruited to invest $500,000 each in return for a fast-tracked citizenship via a federal government program. US Citizenship and Immigration Services rejected the application in saying that the hospital didn’t meet the federal government’s definition of a “troubled business” that would allow wealthy foreigners to buy their US citizenship via investments.

Here is Part 2 of Vince’s HIS-tory of Cerner from a few years back. It’s fascinating to read about Cerner predecessor PGI’s fortuitous entry into health IT when lab systems were catching on and the big players were HBO, Spear, BSL, MedLab, SMS, and McAuto, all long gone since those heady days of 1980. I saw some familiar but also-dead companies on his 1988 list – TDS, Antrim, Citation, and Terrano, for example. I’m peeking ahead at Vince’s next episode and I’m fascinated about how the name Cerner was chosen and by whom.

Weird News Andy pitches a new TV series he’s calling “Ambulance Wars,” even providing a tagline of “Both companies are losing patients.” Houston-area Republic EMS sues rival City Ambulance and its president Mohammad Massoud, claiming that City Ambulance vandalized its ambulances a dozen times in retaliation for losing business and employees to Republic. Republic says City Ambulance hired people to shoot out its ambulance windows, cut the brake lines of one of its ambulances, and covertly installed GPS trackers on its ambulances to harvest client addresses for follow-up advertising.

Sponsor Updates

• Optimum Healthcare IT posts a study of its work on Allegheny Health Network’s Epic Community Connect.

Blog Posts

• Our 4 biggest takeaways from the revised Senate bill (Advisory Board)
• EviCore Designated by CMS as Qualified CDSM for Decision Support Mandate (Qpid Health)
• Demystifying Command Center Coordination (Impact Advisors)
• Can you? Visage can. Vol. 1 Speed | Chapter 8: Priors (Visage Imaging)

   

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

News 7/14/17

Top News

An HHS OIG report finds that one out of three of Medicare Part D’s 44 million prescription drug coverage beneficiaries filled at least one opioid prescription in 2016 at a taxpayer expense of over $4 billion.

Alabama and Mississippi led prescribing rates, as nearly half of their Part D patients received opioids.

HHS finds that 90,000 people are at risk of misuse or overdose due to high doses or apparent doctor-shopping. One patient filled 11 opioid prescriptions in a single month from eight prescribers and six pharmacies across five states.

The report says prescribers must use state PDMP doctor-shopping databases, recommends that HHS crack down on doctors who overprescribe opioids for possible patient resale or recreational use, and urges improved public health surveillance and advancement of pain management practices. 

Reader Comments

From Mel Practice: “Re: lab results. We had a patient harmed because the lab didn’t receive their orders from the EHR due to interface problems. For HIStalk readers, do your nurses track pending results and follow up with the lab or does the EHR auto-alert the provider if no results are reported? What happens when the lab receives a specimen without an order?”

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Five-employee, Seattle-based BloomAPI raises $2.4 million in venture funding to continue development of its EHR information exchange and record release and technology. Founder Michael Wasser also co-founded insurance signup site HealthSherpa as an alternative to Healthcare.gov.

Venture capital firm Canal Partners sells its stake in rehab and therapy EHR vendor WebPT to Battery Ventures for 16 times its original investment.

A Craneware trading update says the company expects to report double-digit revenue and earnings growth in its September report, also noting the first sale of its cloud-based Trisus Claims Informatics solution.

Social services coordination platform vendor Healthify raises $6.5 million in a Series A funding round led by BCBS Venture Partners, increasing its total to $9.5 million.

The fading-fast Theranos lists its Palo Alto, CA headquarters building for partial or complete sublease.

Minneapolis-based medical liability insurance vendor Constellation sells its health IT consulting and analytics business (MMIC Health IT) to Med Tech Solutions.

Sales

New York-Presbyterian (NY) chooses Epic to replace several systems, most notably those of Allscripts. MDRX shares have declined in price by around 7 percent following analyst reports stating that NYP is the fifth-largest Allscripts Sunrise EHR customer, representing 6 percent of its installed base and contributing up to $30 million of the annual revenue of Allscripts.

People

Merrie Wallace, RN, MSN (Premier) joins PerfectServe as chief revenue officer.

SPH Analytics hires Suzanne Cogan, MBA (Orion Health) as chief commercial officer.

AuntMinnie.com International Editor Eric Barnes died July 5.

Announcements and Implementations

USC’s Keck Medicine (CA) goes live on QGenda for publishing ambulatory clinical and call schedules.

Datica publishes its Digital Health Success Framework, which helps digital health developers “take products from napkin scribble to market without any snags.”

Health Fidelity launches a patient data acquisition and aggregation platform for providers and health plans, with its first customer Mount Sinai Health Partners (NY) using it to automate retrieval of Epic patient records for review in bypassing the use of extract-transform-load tools.

Healthcare Growth Partners publishes its mid-year health IT market review, which notes that while digital health investments have increased dramatically, mergers and activities haven’t quite kept up. The economic analysis is, as always, near-poetic in its brilliance:

Last year, HGP discussed the concept of Exploiters and Solvers in the healthcare industry. The US healthcare economy is indisputably inefficient. Inefficient markets create opportunities for exploitation or solution. Exploiters seek to exploit inefficiencies to maximize returns for a select few. Solvers seek to eliminate inefficiencies to maximize returns for many. In the context of healthcare, one can quickly see the potential for moral hazard. Martin Shkreli, for example, is an egregious exploiter.

However, exploiting versus solving in healthcare cannot be taken at face value because economic interests often do not align with patient interests. Martin Shkreli is chastised for his actions, but many stakeholders in the healthcare industry pursue some degree of self-interest at the expense of patients that ultimately utilize their product. Two non-profit health systems in the same region may compete at the expense of the patients they serve. Shkreli just crossed the subjective line of moral hazard.

The basic economic pricing model underscores the disconnect. Pricing is generally the equilibrium (or optimization point) between profit and quantity based on the consumer’s perceived value of the product. In practical terms, this means that a product is priced as high as a customer can bear before choosing a substitute product. The latter definition of pricing certainly sounds like a moral hazard in the context of healthcare, and it would be if the patient were the customer. However, the patient is not the customer because he or she is not part of the economic equation to establish price equilibrium

Piedmont Atlanta Hospital (GA) rolls out Atlanta-based Gozio Health’s mobile way-finding app.

Mayo Clinic’s first sites go live on its $1 billion Epic system.

Government and Politics

HHS’s Medicaid Strike Force charges 412 defendants — including 115 licensed professionals – with fraudulently billing $1.3 billion in medically unnecessary services, many of those incidents involving patient recruiters who were paid kickbacks to provide patient information. Of those charged, the DOJ says 120 were prescribing and/or distributing opioids. 

Paralyzed Veterans of America urges the VA to focus on moving ahead with its Cerner contract negotiation and implementation, explaining that the organization believes that, “Cerner Corp. holds the key to saving the lives of disabled veterans in the future, and doesn’t want it waylaid by political posturing about the bigger healthcare debate.”

Privacy and Security

In England, the government pledges $27 million to help hospitals update their IT systems to protect them against ransomware. NHS Digital will also issue cybersecurity threat alerts, staff an incident hotline, and conduct onsite security assessments.

Other

Here’s Vince’s HIS-tory of Cerner, Part 1 from a few years back to pay tribute to Neal Patterson. I’m thinking about re-running the remaining five parts of the series since I enjoyed them the first time around.

Sponsor Updates

• Optimum Healthcare IT is named a top-rated implementation services firm in a new KLAS report.
• EClinicalWorks describes how its Healow Kids mobile app connects parents with their child’s pediatrician.

Blog Posts

• Passion and Vision for the Future: The Legacy of Neal Patterson (Netsmart)
• CIO Chat – Mike Maksymow, Beebe Healthcare (Huntzinger Management Group)
• Meditech Customers Lead 2017 Great Community Hospitals List (Meditech)
• Can you? Visage can. Vol. 1 Speed | Chapter 7: Thin-Slice Reading (Visage Imaging)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

News 7/12/17

Top News

A memorial service for Cerner co-founder, CEO, and chairman Neal Patterson will be conducted at 11:00 a.m. Central time Thursday at United Methodist Church of the Resurrection in Leawood, KS. The service will also be live-streamed.

Patterson’s extensive and well-written obituary was published in the Kansas City Star and on Cerner’s site.

Reader Comments

From Park City: “Re: Rick Adam. Seems to have left Stanson Health and is now CEO of some Intermountain spinoff called Empiric.” Rick’s LinkedIn profile shows the new job, but it also continues to list his position as president/COO of Stanson and he remains on Stanson’s executive page. The website of Empiric Health says its program is based on Intermountain’s ProComp program. It appears to offer evidence-based, analytics-powered process improvement. Empiric was formed in February 2017 by Intermountain and venture capital firm Oxeon, with Loma Linda University Health as its first customer.

From The Care Rationer: “Re: EviCore. Being bought by UnitedHealth Group.” Unverified, but not surprising if true. The South Carolina-based specialty benefits manager, which focuses on evidence-based cost reduction, was rumored earlier this year to be seeking a sale or IPO, valuing itself in the $4 billion range. The company was formed via the December 2014 merger of CareCore and MedSolutions.

From MerryMe: “Re: IQPC. They reach out to us (as a vendor) about attending their CIO Healthcare Exchange in October in Dallas, dropping a lot of big-hospital names. Is this a viable CIO/CMIO event that would be worth investing in as a sponsor?” I’ll invite readers to comment since I’ve never heard of the event. It’s one of those where the attendees (who I assume get free attendance in the “ladies drink free” model that I’ve experienced) are forced to schedule time with vendors who have paid for captive access to them. Of the 10 listed speakers, four are health system CIOs. The conference is run by IQPC, which claims to offer 2,000 events each year, of which a few are related to healthcare. Sponsors can buy whatever level of influence they can afford – a keynote panel moderator slot, a plenary session speaking session (“the grandest speaking platform at the event”), a half-group session that “is positioned to present the sponsor as a master in the topic,” or the usual giveaways such as meals, WiFi, or hotel key cards.

HIStalk Announcements and Requests

I incorrectly reported a promotion at Agnesian HealthCare (WI) on Monday. Nancy Birschbach is still VP/CIO – the promotion involved the CFO position, not the CIO role.

I’m getting increasingly frustrated by Spotify, of which I’m a premium subscriber. Every time I click the desktop icon, it launches a clunky web page that runs a software update. It used to just do the update automatically upon launching. That’s a minor problem compared to users and web publishers who host their images on the formerly free Photobucket, which in a desperate bid for revenue after adblockers killed its already shaky ad-supported model, decided without warning to start charging users who display their photos on other sites (which is nearly all of them) $400 per year. That action suddenly left broken images all over sites like Amazon, Ebay, Etsy, and blogs as users accuse the company of a ransomware-like tactic in replacing their long-functioning images with a threatening warning graphic and with no easy resolution other than to ante up. I’m curious about the legal standing of such changed terms of service, although I suspect we’ll find out soon enough via a likely class action lawsuit, which better happen quickly to beat the inevitable demise of Photobucket, which was already circling the bowl even before this monumentally stupid management decision.

Listening: The Alan Parsons Project, which I never liked much, but the local low-powered FM station got my attention by playing “Old and Wise,” which I tracked down with Shazam. I was sure it was the Zombies since the singer sounded like Colin Blunstone (who I saw live in a fantastic Zombies concert a few years ago), and sure enough, he did the singing for TAPP on that 1982 album. Maybe I just like Colin.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

In England, healthcare Internet of Things startup Drayson Technologies increases its total funding to $46 million and announces a deal to commercialize technology developed by Oxford University Hospitals NHS Foundation Trust. The company was started in 2015 by former science minister, entrepreneur, and race car driver Paul Drayson.

Healthcare payment analytics vendor Cotiviti will acquire Louisville, KY-based provider performance analytics vendor RowdMap for $70 million.

Healthcare sourcing and contract systems vendor TractManager acquires MedApproved, which offers a hospital new product approval workflow system. The CEO of TractManager – which offers products under the MediTract and MD Buyline names — is former Cerner, TriZetto, and Nuance executive Trace Devanny, who took the job in October 2016.

Hospital pharmacy technology vendor Inmar acquires the MedEx pharmacy logistics product line from Aethon, best known for its TUG delivery robot.

CellTrak Technologies, which offers a homecare care delivery portal, raises $11 million, increasing its total to $23 million.

Published rumors of Amazon’s quiet rollout of a Geek Squad-like home installation and service knocked a billion dollars off the market cap of Best Buy this week. Meanwhile, a study finds that Amazon gets 37 percent of the money consumers spend online, with its Prime subscription and fast delivery setting a bar few other online retailers can meet. I can identify – I always worry that my trash day recycling activities will trigger a concerned neighbor’s “gunshots fired” police visit while I’m deconstructing mountains of Amazon shipping boxes and loudly popping endless strings of the accompanying packing air pillows.

Lexmark’s Perceptive Software product line is folded into Hyland Software’s product portfolio following completion of a previously announced Thoma Bravo buyout of Lexmark’s enterprise software business.

Sales

University of Virginia Medical Center (VA) extends its contract for LogicStream Health’s clinical process improvement solutions.

Three Florida ACOs — Central Florida AVO, Next ACO of Nature Coast, and Space Coast ACO – choose the population health management solution of EClinicalWorks.

The Nebraska Health Information Initiative and the state’s HHS choose DrFirst to capture prescribing information and deliver it to the state’s prescription drug monitoring program database, the first state to require (as of January 1, 2018) the tracking of all prescriptions dispensed (not just opioids) to give pharmacists and physicians a complete medication record for detecting drug-drug interactions and therapy duplication.

Houston Methodist Coordinated Care (TX) chooses PatientPing to give providers real-time notifications when their patients receive care elsewhere.

People

Stanley Crane (Allscripts) joins prescription price comparison and patient adherence technology vendor InteliSys Health as CTO.

Imprivata hires Mark Nesline (Lionbridge) as SVP of engineering.

Jean-Claude Saghbini (Cardinal Health) joins Wolters Kluwer Health as VP/CTO.

Communication, care coordination, and patient education technology vendor CipherHealth hires Lisa Romano, RN, MSN (CareExperience) as chief nursing officer and promotes Barbara Davis, MA to SVP of client success.

Training and HR software vendor HealthStream hires Jeff Cunningham (Informatics Corporation of America) as SVP/CTP and promotes Jeff Doster to SVP/CIO and Scott Fenstermacher to VP/head of sales.

Bonny Roberts (Aventura) joins Diameter Health as VP of customer experience.

Announcements and Implementations

In Canada, Grand River Hospital goes live on Wellsoft’s emergency department information system.

Cardiac Insight releases its Cardea Solo ECG monitoring system that is FDA-approved for monitoring atrial fibrillation following ablation procedures, noting that unlike competitors, it does not require use of a third-party monitoring service and instead sends data directly to the physician. 

Privacy and Security

Nuance updates suggest that the company has still not fully recovered from its malware attack of June 27. A 14-day outage seems problematic for a company  that offers critical cloud-based services globally.

Other

NPR profiles the nurse recruitment strategy of Johns Hopkins All Children’s Hospital (FL), which buys lists of clinicians and then applies “geofencing” technology to pop up recruitment ads on their cellphones when those potential job candidates enter or leave designated physical zones. The hospital says not only is it receiving several resumes weekly vs. none before, it can even serve up ads as nurses head off to work at rival hospitals, adding, “We have invaded their space in which they live and work, so it’s a much better use of our dollars.”

A review finds that while patient-created recordings of their encounters (often made covertly) offer clinical benefit to themselves and malpractice protection for their providers, state wiretapping laws are inconsistent as to which of the two parties must consent. The patient can record their encounter without provider consent in 39 of 50 states plus DC (the light-colored states above are the “single-party consent” states). The authors also note that patient-created recordings are not subject to HIPAA and that patients are free to share those recordings with anyone without permission. While patients are legally allowed to make such recordings in single-party consent states, the physician also has the right to terminate the visit if they don’t want to be recorded. The article did not address the recording of telemedicine visits in which the patient and provider might live in different states.

This might be the jump-the-shark moment for startups. A China-based company whose app allows renting umbrellas from its code-locked public stands (it’s one of an alarming 15 such companies in China) has almost all of its 300,000 umbrellas stolen by renters who didn’t bother to return them (their deposit covered only one-third of the umbrella’s cost and locations to return them are scattered). Unlike two bicycle-sharing startups in China that recently folded when customers stole all of their rolling stock, the company says it will order another 30 million umbrellas and keep trying.

Sponsor Updates

• Datica posts a podcast in which CEO Travis Good, MD interviews Sanjeev Arora, MD about improving rural access to care using telehealth.

Blog Posts

• 4 Questions with Chuck Podesta, CIO of UC Irvine Health (Optimum Healthcare IT)
• Engagement and culture are here to stay (Infor)
• 12 Pitfalls of Electronic Patient Signatures in Registration (Access)
• Bridging the Divide: Engaging Physicians and Nurses in Health IT (Spok)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.